appropriate use criteria
Defined in 1 place of the United States Code.
In this subsection, the term “appropriate use criteria” means criteria, only developed or endorsed by national professional medical specialty societies or other provider-led entities, to assist ordering professionals and furnishing professionals in making the most appropriate treatment decision for a specific clinical condition for an individual. To the extent feasible, such criteria shall be evidence-based.
Source
- 2014–present42 U.S.C. § 1395MThe Public Health and Welfare · Special payment rules for particular items and services · in this section