Physicians: Are you a successful e-prescriber?

The eRx program provides incentive payments to Eligible Professionals (EPs) who are successful electronic prescribers utilizing a qualified eRx system and reporting unique electronic prescribing events. 
 

Do you qualify for the eRx Incentive?

There is no sign-up or pre-registration for individual EPs to participate in the eRx Incentive Program, though there are certain limitations:

• You must have a qualified eRx system in use, and report on adoption and use of that system
• You must meet the criteria for successful electronic prescriber specified by CMS for a particular reporting period
• At least 10% of your Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure (e.g., Current Procedural Terminology [CPT] or Healthcare Common Procedure Coding System [HCPCS] G-codes)

Are you Eligible?

To participate in the eRx Incentive Program, EPs must have prescribing authority. The Medicare eRx Program defines EPs as MD, DO, DDS, DMD, DPM, OD or DC.

For additional information on eligibility, see: http://www.cms.gov/ERxIncentive/05_Eligible%20Professionals.asp#TopofPage
 

How to participate

If you meet the qualifying criteria (eRx system and prescriber) and at least one prescription was created during the encounter and was generated and transmitted electronically, you can then submit G-Code “G-8553” in one of three ways: 1) on your claim; 2) to a qualified registry; or 3) via a qualified EHR. EPs can begin reporting the eRx measure any time during the current calendar year.

To be a successful eRx prescriber and be eligible to receive an incentive payment, you must generate and report one or more electronic prescriptions associated with a patient visit; a minimum of 25 unique visits per year.

Report 10 eRx events during the first six months of the year (January – June) or report eRx measure 25 times for 12-month reporting period (January – December).

Remember:

• You cannot participate in the eRx and the EHR Initiative in the same year
• Faxing is not considered an electronic transmission
• Electronically generated refills do not count
• New prescriptions not associated with a valid visit code are not accepted as an eligible patient visit and do not count towards the minimum unique electronic prescribing events

Key Resources

• eRx Information: http://www.cms.gov/ERxIncentive
• Eligible Professionals: http://www.cms.gov/ERxIncentive/05_Eligible%20Professionals.asp.#TopofPage
• eRx Measure: http://www.cms.gov/ERxIncentive/06_E-Prescribing_Measure.asp#TopofPage
• Analysis and Payment: http://www.cms.gov/ERxIncentive/10_Analysis%20and%20Payment.asp#TopofPage