Am I eligible?

CMS has developed a web tool that can help you determine whether or not you are eligible to participate in the EHR Incentive Programs. Visit the CMS website to determine your eligibility.

Medicare EHR Incentive

The structure for incentives and penalties for Medicare Eligible Professionals (EPs) is as follows:

2014 is the last year to begin participation in the Medicare EHR Incentive program. Payment adjustments for EPs who do not successfully demonstrate Meaningful Use start from 2015.

Medicaid Program Eligibility Criteria

A Medicaid Eligible Provider (EP) must have:

  • A minimum 30% Medicaid patient volume.
  • A minimum 20% Medicaid patient volume, and is a pediatrician.
  • Physician assistants must practice predominantly in a FQHC or RHC and have a minimum 30% patient volume attributable to needy individuals.
  • And Children's Health Insurance Program (CHIP) patients do not count in the Medicaid patient volume criteria.

FAQ's

Can practices participate?

NO

Incentive payments for the Medicare EHR Incentive Program are made to individual providers, not to practices or medical groups. Although a provider can designate a practice to receive the incentive funds on their behalf, it is up to the provider to make this decision—the practice or medical group cannot claim the money or make the decision for the provider, even if the EHR belongs to the practice.

Can Eligible professionals who are hospital based participate?

NO

Eligible professionals who are hospital-based cannot participate in the EHR Incentive Programs. A provider is considered hospital-based if he or she provides more than 90% of their covered professional services in either an inpatient (Place of Service 21) or emergency department (Place of Service 23) of a hospital.CMS makes the determination if you are hospital-based. You will find out your status when you register for the program.

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This information is accurate, to the best of our knowledge. As more information becomes available from HHS and other agencies, this page will be updated accordingly. Please check the CMS website.
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