Appropriate Use Criteria Program: CMAs (AAMA)® Meet Clinical Staff Criteria under the CMS Rule

In the Public Affairs article of the March/April 2018 CMA Today, I argued that “appropriately educated and credentialed medical assistants” such as CMAs (AAMA)® are clinical staff under the Medicare Chronic Care Management (CCM) and Transitional Care Management (TCM) programs.

I now add that CMAs (AAMA) are also clinical staff according to the Centers for Medicare & Medicaid Services (CMS) rule regarding the appropriate use criteria (AUC) program. Therefore, as a result of their clinical staff status, I assert that CMAs (AAMA) are permitted to do the following:

1. Consult a clinical decision support mechanism (CDSM) about the appropriateness of ordering a particular advanced diagnostic imaging service
2. Report findings to their overseeing or delegating licensed providers

Review the supporting evidence in the September/October 2019 Public Affairs article, “Appropriate Use Criteria Program,” on the AAMA website.