Watch for E-Prescribing Overpayment

Texas Medicare contractor Novitas Solutions has identified a problem with the e-prescribing payment reduction file for 2012 dates of service. The system is not processing the 1-percent reduction for 2012 dates of service.

This is resulting in overpayments for physicians subject to the applicable e-prescribing penalty. Novitas is working to resolve this problem. Watch the Novitas System Alerts for an update. 

Who is subject to the 1-percent penalty? If you did not e-prescribe and report the G-code G8553 at least 10 times by June 30, 2011, or claim a valid exemption by Nov. 7, 2011, you were penalized 1 percent of your 2012 Medicare Part B claims. Some of your claims for 2012 will include the overpayment. 

2013 E-Prescribing Reminder 

You have until June 30 to avoid a 2-percent penalty on all 2014 Medicare Part B claims. If you do not already e-prescribe in your office, now is the time to begin. If you do not already use an electronic health record (EHR) system with e-prescribing capabilities, you can install a stand-alone e-prescribing system and still meet the approaching deadline. You must report e-prescribing via claims using G-code G8553 on at least 10 unique Medicare encounters by June 30 to prevent the penalty. Three prescriptions for one patient encounter will count as only one e-prescribing incident.

Find out more on the TMA 2013 E-Rx Penalty and Incentive Guidelines page. If you need help with e-prescribing, turn to the Texas regional extension centers (RECs). RECs provide support to help with e-prescribing, EHR selection, workflow analysis, staff training, EHR incentives, and much more. Visit TMA’s Texas REC Resource Center for more information.

Published Feb. 26, 2013


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