New Medicare Regulation to take effect Jan 1, 2022

PAMA - Protecting Access to Medicare Act of 2014

PAMA is a program regulated by Medicare to increase the rate of appropriate advanced diagnostic imaging services provided to Medicare beneficiaries.

CareSelect Portal

If a qualified CDSM is not available to you, we are providing access to our qualified CDSM tool, CareSelect. Please self-register by following the login process. If you have already created a CareSelect login, sign in:

What services are considered advanced imaging?

CT
MRI
Nuclear Medicine
PET

Why has Medicare created this new regulation?

To ensure that advanced imaging services ordered for Medicare beneficiaries are medically necessary.

Who is responsible?

Any provider ordering or furnishing advanced imaging services.

When will this regulation take effect?

The start date is set for January 1, 2022.

How will Medicare know that the CDSM was utilized?

Ordering providers will need to provide their imaging facility of choice with two codes that will document:

  1. That a qualified Clinical Decision Support Mechanism (CDSM) was used. This code will begin with a G.
  2. That the advanced imaging being ordered is appropriate and medically necessary. This code will be a two-letter Healthcare Common Procedural Coding System (HCPCS) modifier code.

Additional Resources

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