Medicare Physicians Alert!

Don’t Miss Out On Your Medicare E Prescribing Incentive Money

E Prescribing: Do You Qualify For Medicare E Prescribing Incentive Money?

Were you successful in getting the 1% Medicare e Prescribing incentive money for 2011? Or were you one of the health care providers who are getting hit with the 1% e prescribing penalty because you didn’t e prescribe in 2011?

It’s 2012 and you now have the same opportunity and potential liability. There’s something called Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). MIPPA is an electronic prescription drugs program alternately referred to as the Medicare eRx incentive program or Medicare e-prescribing incentive program.

Under MIPPA, Medicare health care providers could have received incentive payments for e prescribing in the 5 year period ending in 2013.

What’s the basic CMS Medicare e Prescribing requirements?

  • 25 unique e prescribing events
  • 10% total Medicare Part B with appropriate g-code G8553
  • eligible patient visit procedure denominator codes:
    • Current Procedural Terminology (CPT) codes or
    • Healthcare Common Procedure Coding System (HCPCS) G-codes.

How to report the eRx data?

You can report e prescribing data using one of three options:

1. Claims-based (CMS 1500) reporting of the eRx G-code G8553.

2. Registry-based reporting using a Centers for Medicare and Medicaid Services (CMS) designated registry to submit 2011 data to CMS during the first quarter of 2012.

3. EHR-based reporting using CMS / ONC HITECH Act certified electronic health record (EHR) / electronic medical record (EMR) systems to submit 2012 data to CMS during the first quarter of 2012

CMS 1500 E Prescribing: - Do You Qualify For Medicare E Prescribing Incentive Money?

Who is MIPPA e prescribing Eligible Professional?

First of all you have to prescribe prescription drugs. Then you must fall into one of the following eligible professional categories

1. Medicare physicians

• Doctor of Medicine (MD)
• Doctor of Osteopathy (DO)
• Doctor of Podiatric Medicine (DPM)
• Doctor of Optometry
• Doctor of Oral Surgery
• Doctor of Dental Medicine
• Doctor of Chiropractic

2. Practitioner

• Physician Assistant (PA)
• Nurse Practitioner* (NP)
• Clinical Nurse Specialist*
• Certified Registered Nurse Anesthetist* (and Anesthesiologist Assistant)
• Certified Nurse Midwife*
• Clinical Social Worker
• Clinical Psychologist
• Registered Dietician
• Nutrition Professional
• Audiologists

*Includes Advanced Practice Registered Nurse (APRN)

3. Therapists

• Physical Therapist
• Occupational Therapist
• Qualified Speech-Language Therapist

There is no pre-registration required for the Medicare e-Prescribing program. But you must follow the rules to get your E Prescribing incentives.

Got questions?
about the HITECH Act, Electronic Medical Records or the
Centers for Medicare Medicaid Services (CMS)
EHR incentive program

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