Will a procedure still be reimbursed if it does not adhere to the Appropriate Use Criteria?

Yes- if a furnishing provider submits the certificate of proof that the CDSM was consulted, they will still be reimbursed for the procedure even if it is declared non adherent or not applicable according to the AUC guidelines. However, in the future, CMS may require that ordering providers with a high rate of nonadherent procedures will be required to get prior authorizations.