ePrescribing
Receive 2% of Medicare Part B Charges with ePrescriptions!
For 2009, e-prescribing incentive amounts will be 2% of the total estimated allowed charges for professional services covered by Medicare Part B and furnished by an eligible professional during the reporting year (one calendar year).
Overview of Medicare
Part B Incentive Payments |
| If you Qualify for the
Calendar Year: |
Your Incentive Payment is: |
| 2009 |
2.0% |
| 2010 |
2.0% |
| 2011 |
1.0% |
| 2012 |
1.0% |
| 2013 |
0.5% |
| *You must submit claims
no later than 2 months after the reporting period ends. |
You are eligible for this incentive if:
You are a professional physician, physical/occupational therapist, qualified speech-language pathologist, nurse practitioner, physician assistant, clinical nurse specialist, certified registered nurse, anesthetist, certified nurse midwife, clinical social worker, clinical psychologist, registered dietitian, nutrition professional or a qualified audiologist (as of 2009).
You must also be a successful "e-prescriber," meaning you must
report the e-prescribing quality measure through your Medicare
Part B claims on at least 50% of applicable cases during
the reporting year.
For more information about electronic prescribing and this
incentive, please click here
ePrescribing Incentive Program
This information available on the Centers for Medicare & Medicaid Services (CMS) website here.
First - Determine if you are eligible for an incentive payment.
Requirements for eligibility:
- Routinely use and eRx system that has the following capabilities:
- Generate a complete active medication list incorporating electronic data received from applicable pharmacies and pharmacy benefit managers (PBMs), if available.
- Select medications, print prescriptions, electronically transmit prescriptions, and conduct all alerts.
- Provide information related to lower cost, therapeutically appropriate alternatives, if any (the availability of an eRx system to receive tiered formulary information would meet this requirements for 2010).
- Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient’s drug plan, if available.
- Medicare Part B Physician Fee Schedule (PFS) charges for the codes in the denominator of the measure in the list below must make up at least 10% of total Medicare Part B PFS allowed charges for 2010.
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, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109
If you qualify, then you should report the measure as follows:
When you bill of the CPT or HCPCS G-codes in the above list, report the following G-code (numerator code) on the claim form that is submitted for the Medicare patient visit.
G8553 - (At least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx System.)
- Generate and report at least one electronic prescription associated with a patient visit, at least 25 unique visits per year. (Refills do not count as unique, and faxes to not qualify as an electronic prescription).
- At least 10% of an eligible professional's Medicare Part B charges must be comprised of the codes in the denominator of the measure to be eligible for an incentive.
Note: You do not need to register to participate in the eRx incentive program.
For more information on the eRx incentive, please click here.
What is e-prescribing?
Electronic prescribing is an electronic way to generate prescriptions through an automated system over the internet that transmits to a network which links to participating pharmacies.
Benefits of e-prescribing:
- Improving patient safety and overall quality of care - Illegible hand-written prescriptions are eliminated, decreasing the risk of medication errors and decreasing liability risks.
- Reducing or eliminating phone calls and call-backs to pharmacies - Physician offices are overwhelmed by call-backs from pharmacies with questions, clarifications and refill requests.
- Increases patient compliance - Approximately 20% of paper prescriptions go unfilled by the patient. E-prescribing systems expedite the filling of prescription at the pharmacy.
- Improving Formulary adherence. By checking with insurance company formularies, generic substitutions are encouraged thus reducing patient costs.
- Improves reporting ability. Prescription reporting would be impossible with a paper prescription system. Electronic prescriptions can be easily reported on such as:
- finding all patients who have had a particular medication prescribed to them during a drug recall
- the frequency of medication prescribed by certain providers etc.
What your practice needs to do to get started e-prescribing:
Electronic prescriptions are tightly integrated to EMR software. Therefore, to achieve the full benefits of
ePrescribing, consider it as part of a complete EMR implementation.
Part of the complete medical office suite
Our integrated EMR, ePrescribing and Practice Management solutions offer the best value for your medical practice.
For more information, contact our consultants. Call 800-955-0321 or
click here.