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A major Electronic Prescribing (eRx) Incentive Program deadline is approaching for both individual eligible professionals (EPs) and group practices participating in the Group Practice Reporting Option (GPRO).  If you are an EP or an eRx GPRO participant, you must successfully report as an electronic prescriber before June 30, 2013 or you will experience a payment adjustment in 2014 for professional services covered under Medicare Part B's Physician Fee Schedule (PFS.)

The 2013 eRx Incentive Program 6-month reporting period (January 1, 2013 to June 30, 2013) is the final reporting period available to you if you wish to avoid the 2014 eRx payment adjustment.

If you do not successfully report, a payment adjustment of 2.0% will be applied, and you will receive only 98.0% of your Medicare Part B PFS amount for covered professional services in 2014.

Avoiding the 2014 eRx Payment Adjustment
Individual EPs and eRx GPRO participants who were not successful electronic prescribers in 2012 can avoid 2014 eRx payment adjustment by meeting specified reporting requirements between January 1, 2013 and June 30, 2013.Below are the6-month reporting requirements:

  • Individual EPs – 10 eRx events via claims
  • eRx GPRO of 2-24 EPs – 75 eRx events via claims
  • eRx GPRO of 25-99 EPs – 625 eRx events via claims
  • eRx GPRO of 100+ EPs – 2,500 eRx events via claims

Exclusions and Hardships Exemptions
Exclusions from the 2014 eRx payment adjustment only apply to certain individual EPs and group practices, and CMS will automatically exclude those individual EPs and group practices who meet the criteria. More information on exclusion criteria and hardship exception categories can be found on the Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.

Resources from CMS
Additional resources on the 2014 payment adjustment are available on the eRx Incentive Program Payment Adjustment Information webpage, including the resource Electronic Prescribing (eRx) Incentive Program: Updates for 2013.

Questions about eRx?
If you have questions regarding the eRx Incentive Program, eRx payment adjustments, or need assistance submitting a hardship exemption request, please contact the QualityNet Help Desk at 866-288-8912 (TTY 1-877-715-6222) or via This email address is being protected from spambots. You need JavaScript enabled to view it. . The Help Desk is available Monday through Friday from 7am-7pm CT.To learn more about the eRx Incentive Program and program alignment under the CMS eHealth initiative, please visit

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The Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs are effective today!  Please see the CMS website ( to see if you meet the eligibility requirements by law to participate in the Medicare and Medicaid EHR Incentive Programs.

If you do meet the requirements, registration for the Medicare and Medicaid EHR Incentive Programs started today, January 3, 2011.  Please visit the CMS website ( to register.

If you have any questions or concerns if your practice is eligiable for incentives or need help registering, please call Advanced Billing Consultants, Inc, your all in one medical billing service, at 888-222-2125 and we will assist you.

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A number of measures for Meaningful Use objectives for eligible hospitals and critical access hospitals (CAHs) include patients admitted to the Emergency Department (ED). Which ED patients should be included in the denominators of these measures for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs?

On September 17, 2010, we issued an FAQ that explained that our intent to include in the denominator visits to the emergency department (ED) of sufficient duration and complexity that all of the Meaningful Use objectives for which the ED is included would be relevant.  Therefore we explained that eligible hospitals and CAHs should count in the denominator patients admitted to the inpatient part of the hospital through the ED, as well as patients who initially present to the ED and who are treated in the ED’s observation unit or who otherwise receive observation services.

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The Centers for Medicare & Medicaid Services (CMS) issued an interim final regulation on May 5, 2010 implementing provisions of the Affordable Care Act that permit only a Medicare-enrolled physician or eligible professional to certify or order home health services, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), and certain items and services under Medicare Part B. The new law applies to orders, referrals and certifications made on or after July 1. However, according to a June 30, 2010 press release from CMS, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in the Provider Enrollment, Chain and Ownership System (PECOS).

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