Gov't Affairs

Medicare ePrescribing Incentives

Legislation: The Medicare Improvements for Patients and Providers Act (MIPPA)

The ePrescribing incentive program ends after 2014—the last incentives were earned in 2013 and penalties for non-participation will be incurred through 2014, according to the chart below. Incentives and penalties are calculated as a percentage of estimated total Medicare Part B Fee-For-Service Allowed Charges submitted by the end of February of the following year, according to the following schedule:

Year ePrescribing Bonus Non-ePrescribing Penalty
2009 2% - paid Fall 2010
2010 2% - paid Fall 2011
2011 1% - paid Fall 2012
2012 1% - paid Fall 2013
1%
2013 0.5% 1.5%
2014
2%

 

2014 ePrescribing Penalties:

To avoid the 2014 ePrescribing penalty, Program-eligible providers had to complete any one of the following actions:

  • ePrescribed and used the code G-8553 on 25 Medicare encounters (with specified CPT codes) between January and December 2012
  • ePrescribed and used the code G-8553 on 10 Medicare encounters (with any CPT codes) between January 1 and June 30, 2013
  • Earned a 2012 Meaningful Use (EHR) Incentive or earned a 2013 Meaningful Use (EHR) Incentive by June 30, 2013
  • Adopted a certified EHR and registered for the EHR Incentive Program for the first time between January 1 and June 30, 2013
  • Requested a Hardship Exemption by June 30, 2013.
  • Submitted G-8642 to indicate practicing in a rural area, G-8643 to indicate insufficient pharmacies, or G-8644 to indicate lack of prescribing privileges. (The relevant code only needed to be submitted on one Medicare claim during the reporting period.)

For more information:

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