Electronic Prescribing:  eRx Incentive Program Exceptions

Providers who fail to electronically prescribe during 10 Medicare E&M visits (denominator codes) between January 1, 2011 and June 30, 2011, may be subject to a 1% reduction in Medicare payments in 2012 and a 1.5% reduction in 2013 with the following 5 exceptions.

1. Your denominator codes (E&M visits) do not meet the 10% minimum requirement as stipulated for the incentive (don’t assume, run the report to make absolutely positive).
2. You do not have at least 100 claims that contain an encounter code that falls within the denominator codes for the period of time January 1, 2011 to June 30, 2011.
3. You are not a physician (MD, DO, or podiatrist), nurse practitioner, or physician assistant as of June 30, 2011 or you do not have prescribing privileges (you’ll report G8644 to be considered for this exemption).
4. You practice in a rural area with limited high speed internet access (you’ll report G8642 to be considered for this hardship).
5. You practice in an area with limited available pharmacies for electronic prescribing (you’ll report G8643 to be considered for this hardship).