Question:
What is the time frame for AUC implementation? I’ve heard there will be no penalties for noncompliance in 2020.
Answer:
For the year 2020, the Appropriate Use Criteria (AUC) program will operate in an education and operations testing period when claims will not be denied if they fail to include proper AUC consultation. Inclusion and active participation are encouraged to transition accordingly. However, for 2021, failure to adhere will carry significant consequences. Expect to receive zero payment on claims that fail to comply. This means that payment will be denied for the professional and technical components along with any charges billed globally.
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