By now most providers are aware that in order to receive an ePrescribing incentive certain requirements for at least 25 unique ePrescribing events must be met. But what some may not realize is that CMS will determine which eligible professionals (EP) are subject to a payment penalty in 2012 based on claims data from Jan. 1, 2011 – June 30, 2011. CMS will analyze the claims during the first six months of 2011 to determine if the EP has submitted at least 10 electronic prescriptions with the G-code 8553. If not a 1% payment adjustment will occur with regard to the EPs Part B-covered professional services. Hardship exemptions may be requested using a ‘hardship’ G-code.
To receive a 2011 ePrescribe Incentive, eligible professionals:
- 1% Incentive Payment (not applicable to professional receiving 2011 incentive from Medicare EHR Incentive Program*.)
- Must use a qualified eRX system
- Report the 2011 eRX measure of G8553 with a qualified procedure code
- Report this G8553 for at least 25 unique eRX events with the applicable denominator during the reporting period
- At least 10% of the eligible professional’s charges based on codes:-Denominator – 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109
*Important Note: Providers who elect to participate in the Medicare EHR Incentive Program do not qualify for ePrescribe incentives but must also report the ePrescribe G-code on at least 10 unique eRX events in 2011 to avoid an eRX payment adjustment in 2012.
Please refer often to http://www.cms.gov/ERxIncentive/ as more information regarding ePrescribing incentives.
****REMINDER – it is not too late to participate in 2010 ePrescribe incentives. Contact us for details.