Frequently Asked Questions

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FAQ

By Topic: Electronic Health Records Incentive Programs Subtopic: Eligible Professionals


[EHR Incentive Programs] If an eligible professional (EP) sees a patient in a setting that does not have ce...
Starting in 2013, an EP must have access to Certified EHR Technology at a location in order to include patients seen ... (more)

[EHR Incentive Programs] When eligible professionals work at more than one clinical site of practice, are t...
CMS considers these two separate, but related issues.Meaningful use: Any eligible professional demonstrating mean... (more)

[EHR Incentive Programs] In order to receive payments under the Medicare and Medicaid Electronic Health Rec...
In order to receive Medicare EHR incentive payments, EPs, eligible hospitals, and critical access hospitals must have... (more)

[EHR Incentive Programs] My practice does not typically collect information on any of the core, alternate c...
EPs are not excluded from reporting clinical quality measures, but zero is an acceptable value for the CQM denominato... (more)

[EHR Incentive Programs] Do specialty providers have to meet all of the meaningful use objectives for ...
For eligible professionals (EPs) who participate in the Medicare and Medicaid EHR Incentive Programs, there are a tot... (more)

[EHR Incentive Programs] For the Medicare and Medicaid EHR Incentive Programs, when a patient is only seen ...
The EP can include or not include those patients in their denominator at their discretion as long as the decision app... (more)

[EHR Incentive Programs] What lab tests should be included in the denominator of the measure for the "incor...
For the "incorporate clinical lab-test results" objective, the denominator consists of the number of lab tests ordere... (more)

[EHR Incentive Program] I am an eligible professional (EP) who has successfully attested for the Medicare E...
For EPs, incentive payments for the Medicare EHR Incentive Program will be made approximately four to eight weeks aft... (more)

[EHR Incentive Programs] Can an eligible professional (EP) implement an electronic health record (EHR) syst...
For a Medicare EP's first payment year, the EHR reporting period is a continuous 90-day period within a calendar year... (more)

How is hospital-based status determined for eligible professionals in the Medicare and Medicaid Electronic ...
A hospital-based eligible professional (EP) is defined as an EP who furnishes 90% or more of their covered professional ... (more)

[EHR Incentive Programs] What is the earliest date the payment adjustments will start to be imposed on Medi...
Medicare payment adjustments will begin in 2015 for EPs and eligible hospitals that do not demonstrate meaningful use... (more)

[EHR Incentive Programs] For the meaningful use objective to "record and chart changes in vital signs" for ...
An exclusion for this objective is provided only for EPs who either see no patients 2 years or older, or who believe ... (more)

[EHR Incentive Programs] Can two separate practices with two different Tax Identification Numbers (TINs) pu...
Yes. Incentive payments are made based on the demonstration of meaningful use by individual eligible professionals (E... (more)

[EHR Incentive Programs] For the Medicaid EHR Incentive Program, how are the reporting periods for Medicaid...
Regardless of when the previous incentive payment was made, the following reporting periods apply for the Medicaid EH... (more)

[EHR Incentive Programs] If an eligible professional (EP) in the Medicaid EHR Incentive Program wants to le...
EPs may use a clinic or group practice's patient volume as a proxy for their own under three conditions:(1) T... (more)

[EHR Incentive Programs] When calculating Medicaid patient volume or needy patient volume for the Medicaid ...
There are multiple definitions of encounter in terms of how it applies to the various requirements for patient volume... (more)

[EHR Incentive Programs] For the "Incorporate clinical lab-test results" menu objective of the Medicare and...
For the "Incorporate clinical lab-test results" menu objective, a provider's certified EHR technology might return a ... (more)

[EHR Incentive Programs] Are professional services rendered by physicians or other eligible professional th...
No. The Health Information Technology for Economic and Clinical Health (HITECH) Act created an EHR incentive payment ... (more)

[EHR Incentive Programs] Are mental health practitioners eligible to participate in the Medicare and Medica...
Mental health providers would only be eligible for incentive payments if they meet the criteria of a Medicare or Medi... (more)

[EHR Incentive Programs] If an eligible professional (EP) does not accept assignment for Medicare Part B, i...
An EP that is not a Medicare participating physician or supplier, but still submits claims to Medicare for Part B phy... (more)

[EHR Incentive Programs] Are Medicaid eligible professionals (EPs) and eligible hospitals subject to paymen...
There are no payment adjustments or penalties for Medicaid providers who fail to demonstrate meaningful use.F... (more)

[EHR Incentive Programs] Can eligible professionals (EPs) use clinical quality measures from the alternate ...
No, if EPs report data on all three clinical quality measures from the core set, they would not report on any from th... (more)

[EHR Incentive Programs] Are optometrists considered eligible professionals for the Medicaid EHR Incen...
Under Medicare, a doctor of optometry is considered a physician (and therefore an EP) with respect to all services the o... (more)

[EHR Incentive Programs] Under the Medicaid EHR Incentive Program, can a qualifying eligible professional (...
Yes, EPs are permitted to reassign their incentive payments to their employer or to an entity with which they have a ... (more)

[EHR Incentive Programs] For the Medicaid EHR Incentive Program, can a non-hospital based eligible professi...
Yes, an EP who sees patients in an in-patient setting, and is not hospital based, can include the in-patient encounte... (more)

[EHR Incentive Programs] Do providers have to contribute a minimum dollar amount toward their certified EHR...
There is no general requirement under the Medicare and Medicaid EHR Incentive Programs for providers to contribute a ... (more)

[EHR Incentive Programs] Will the resident physicians be eligible to participate in the Medicare and Medica...
For the Medicaid EHR Incentive Program, all eligible professionals must meet their state's scope of practice rules to pa... (more)

[EHR Incentive Programs] For large practices, will there be a method to register all of the Eligible Profes...
In April 2011, CMS implemented functionality that allows an EP to designate a third party to register and attest on h... (more)

[EHR Incentive Programs] Is my practice eligible to receive incentive payments through the Medicare and Med...
Incentive payments are not made to practices but to individual eligible professionals (EPs). For more information abo... (more)

[EHR Incentive Programs] If an eligible professional (EP) meets the criteria for both the Medicare and Medi...
EPs   Yes. EPs who meet the eligibility requirements for both the Medicare and Medicaid incentive programs ... (more)

[EHR Incentive Programs] Will academic physicians employed by an academic medical center billing under the ...
Physicians who furnish substantially all, defined as 90% or more, of their covered professional services in either an... (more)

Are physicians who practice in hospital-based ambulatory clinics eligible to receive Medicare or Medicaid e...
A hospital-based eligible professional (EP) is defined as an EP who furnishes 90% or more of their services in either in... (more)

[EHR Incentive Programs] Are eligible professionals (EPs) who practice in State Mental Health and Long Term...
The setting in which a physician, nurse practitioner, certified nurse-midwife, or dentist practices is generally irre... (more)

[EHR Incentive Programs] Can providers participating in the Medicare or Medicaid Electronic Health Record (...
Yes, providers who have registered for the Medicare or Medicaid EHR Incentive Programs may correct errors or update info... (more)

[EHR Incentive Programs] Under the Medicaid EHR Incentive Program, is there a minimum number of hours per w...
Yes, a part-time EP who meets all other eligibility requirements could qualify for payments under the Medicaid EHR In... (more)

[EHR Incentive Programs] Do Federally Qualified Health Center (FQHC) sites have to meet the 30% minimum Med...
Eligible professionals may participate in the Medicaid EHR Incentive Program if: 1) They meet Medicaid patient volume... (more)

If I am receiving payments under the CMS Electronic Prescribing (eRx) Incentive Program, can I also receive...
No, if an eligible professional (EP) earns an incentive under the Medicare EHR Incentive Program, he or she cannot recei... (more)

[EHR Incentive Programs] Will ambulatory surgical centers be eligible for incentive payments under the Medi...
Ambulatory surgical centers are not eligible for EHR incentive payments. The following types of institutional provide... (more)

[EHR Incentive Programs] What are the requirements for dentists participating in the Medicaid EHR Incentive...
Dentists must meet the same eligibility requirements as other eligible professionals (EP) in order to qualify for pay... (more)

[EHR Incentive Programs] Are there any special incentives for rural providers in the Medicare and Medicare ...
Under the Medicare EHR Incentive Program, the maximum allowed charge threshold for the annual incentive payment limit... (more)

[EHR Incentive Programs] Are the criteria for needy patient volumes under the Medicaid EHR Incentive Progra...
Criteria for minimum patient volumes attributable to needy individuals apply only to EPs practicing predominantly in ... (more)

[EHR Incentive Programs] What if a group of providers purchase and share certified EHR technology, can the ...
Yes, but only the portion that pertains to the specific CAH.  If there is a special arrangement whe... (more)

[EHR Incentive Programs] We are a tribal clinic with one full-time physician, one part-time pediatrician, o...
Clinics are not directly eligible for the Medicaid EHR Incentive Program payments, however if the practitioners at yo... (more)

[EHR Incentive Programs] Can eligible professionals participate in the 2011 Physician Quality Reporting Sys...
The Physician Quality Reporting System, eRx Incentive Program, and EHR Incentive Program are three distinctly separat... (more)

Are physicians who work in hospitals eligible to receive Medicare or Medicaid electronic health record (EHR...
Physicians who furnish substantially all, defined as 90% or more, of their covered professional services in either an in... (more)

[EHR Incentive Programs] Is data sharing with neighboring States permitted regarding total Medicaid days fo...
Yes. The CMS Stage 1 final rule  clarifies the policy about calculating patient volume for Medicaid provide... (more)

[EHR Incentive Programs] How does CMS define pediatrician for purposes of the Medicaid EHR Incentive Program?
CMS does not define pediatrician for this program. Pediatricians have special eligibility and payment flexibilities o... (more)

[EHR Incentive Programs] Are physicians who are employed directly by a tribally-operated facility and who m...
Physicians are one of the categories of eligible professionals under the Medicaid EHR Incentive Program. If they... (more)