CMS Electronic Prescribing Incentive Program
Update!CMS Electronic Prescribing Incentive Program changes for 2010 include:
- Skilled nursing facility and home care are now eligible services
- Eligible professionals need only report 25 separate electronic prescribing events during the reporting period
- Eligible professionals will only report one G-code that reflects at least one prescription created during the encounter was generated and transmitted electronically using a qualified electronic prescribing system. Note: By Dec. 13, 2009, CMS will post the new G-code to be used for 2010 reporting on its Web site.
- Data may be reported on the 2010 ePrescribing measure through claims, a qualified registry, or a qualified EHR product. CMS will post a list of qualified registries and qualified EHR vendors and products for the 2010 E-Prescribing Incentive Program on its Web site.
- Group practices (200 or more eligible professionals) must be selected to participate in the PQRI group practice reporting option.
- Group practices must report the 2010 ePrescribing measure at least 2,500 times during the reporting period to be considered a successful electronic prescriber.
- Group practices may choose to report the ePrescribing measure through claims, a qualified registry, or qualified EHR product.
- Group practices interested in participating in the 2010 PQRI through the group practice reporting option are required to submit a self-nomination letter to CMS, requesting to participate in the 2010 PQRI group practice reporting option. Instructions for submitting the self-nomination letter will be posted on the PQRI section of the CMS Web site by Nov. 15, 2009.
ePrescribing incentive program resources
This frequently asked questions (FAQ) flier will help providers determine their eligibility for the incentive program and learn more about the reporting requirements. Providers may also consult the following resources:
- Instructions to obtain PQRI feedback reports, MLN Matters, October 2009
- ePrescribing Incentive Program and PQRI coding and reporting principles, MLN Matters, September 2009
- Sample CMS-1500 claim form
- List of Medicare allowed frequency and charges by specialty from 2007
- presentations from the AMA House of Delegates Interim 2008 meeting: Electronic Prescribing Incentive Program and SureScripts-RxHub electronic prescribing overview
Find general information about e-prescribing in "A Clinician's Guide to Electronic Prescribing."
ePrescribing incentive program background
Starting in January 2009, the Centers for Medicare and Medicaid Services (CMS) will offer eligible providers incentive payments when they use an electronic prescribing (e-prescribing) system to prescribe for Medicare patients. The CMS Electronic Prescribing Incentive Program was authorized by the “Medicare Improvements for Patients and Providers Act of 2008; (MIPPA), which became law on July 15, 2008.
For 2009 and 2010, e-prescribing incentive amounts will be 2% of a provider's total estimated allowed charges for covered professional services during the reporting period (one calendar year). The incentive amount reduces to 1 percent in 2011 and 2012 and finally to 0.5 percent in 2013.