Radiology Outpatient Ordering Transmission (ROOT) Act

The Radiology Outpatient Ordering Transmission (ROOT) Act would overhaul how Medicare collects and uses data around appropriate use criteria (AUC) for applicable imaging services. Starting January 1, 2026, the Secretary of Health and Human Services would receive more detailed information from qualified clinical decision support mechanisms (QCDSM) regarding imaging orders, rather than relying solely on documentation or certifications previously provided to ordering professionals. The bill also requires that, from 2026 onward, the furnishing professional include the ordering professional’s national provider identifier (NPI) on claims for these imaging services. It creates a new framework to identify and address “low compliant” ordering professionals (based on how often they consult a QCDSM) and contemplates potential enforcement tools such as prior authorization and payment adjustments. The bill also mandates ongoing evaluation and reporting every five years (beginning in 2031) and asks for specialty society endorsement to guide AUC criteria, aligning with established regulatory approaches. In short, ROOT shifts data collection toward automated reporting from decision-support systems, ties payment-administration considerations to compliance metrics for ordering clinicians, and sets up oversight, exemptions, and periodic review to influence imaging utilization.