As Congress in 2014 worked on legislation to replace Medicare’s physician payment formula, lawmakers also inserted a mandate for radiologists to consult with clinical decision support software before ordering advanced diagnostic imaging examinations that include CT, MRI, PET and nuclear medicine.
To be reimbursed by Medicare, physicians have to confirm the appropriateness of an exam by first consulting with an evidence-based clinical decision support system (CDS) before an exam is ordered. The mandate was to be effective in January 2017 but the Centers for Medicare and Medicaid Services has pushed that date back to at least mid-2017 as it continues to confer with the industry to determine how the confirmation process will work.
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