Registration for the Medicare Electronic Health Record (EHR) Incentive program is open. Participate early in order to get maximum incentive payments!
To qualify for the Medicare incentive program, you must be using a certified EHR product and meet the meaningful use criteria for 90 days in the first year of program participation. Following your first year of participation, meaningful use will be required for the entire year. You will be able to report data online through attestation. Use the online eligibility tool from the Centers for Medicare and Medicaid Services (CMS) to verify program eligibility prior to enrollment. CMS will allow a physician to enroll prior to completing the meaningful use criteria and return later to complete reporting and attestation.
What can I do now?
Step 1: Select and adopt a certified EHR
Step 2: Meet the meaningful use criteria (quick glance criteria; TMA Meaningful Use Achievement Toolkit; and in-depth criteria)
Step 3: Register for the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)
Step 4: Register at the CMS Registration and Attestation Portal
What can I do later?
Step 5: Obtain EHR certification code (instructions)
Step 6: Complete reporting and attestation
Step 7: Receive incentive payment
Step 1: Select and adopt a certified EHR
The Medicare federal incentive program requires the use of a certified EHR. The Office of the National Coordinator (ONC) maintains the Certified Health IT Product List (CHPL), a current list of all certified EHR products. Even if your current product has met previous certifications, be sure your current version is listed.
If you need help finding or selecting an EHR system, you may benefit from technical consulting services from the Texas Regional Extension Centers (RECs). The RECs are vendor neutral and can help you find a system that fits the needs and budget of your practice.
Step 2: Meet the meaningful use criteria
In your first year of the program, the Medicare EHR Incentive program requires each physician to meet Stage 1 meaningful use criteria for 90 continuous days. Physicians must complete a set of 15 core criteria and choose 5 from 10 criteria on a menu set. For more information on meaningful use, view the one-hour TMA Meaningful Use Webinar. Following your first year, you are required to meet meaningful use for the entire calendar year.
As part of the meaningful use criteria, you will be required to e-prescribe. You will not be able to receive both the Medicare EHR incentive and the e-prescribing incentive in the same year. However, in order to avoid e-prescribing penalties in 2014 (2 percent of Medicare Part B claims), physicians needed to report e-prescribing via claims using G-code G8553 on at least 10 unique Medicare encounters by June 30, 2013. If you did not meet this deadline, you may still be eligible for an e-prescribing exemption. Meaningful use requires you to generate and transmit permissible prescriptions for more than 40 percent of all permissible prescriptions.
Step 3: Register for PECOS
To qualify for Medicare incentives, you must be enrolled in the Provider Enrollment Chain and Ownership System (PECOS). It is possible for you to be actively billing Medicare and not be enrolled in the PECOS system. If you have not enrolled, visit the PECOS website to create an account. Questions? View PECOS contact information.
There are several ways you can verify enrollment in PECOS.
- CMS maintains a current list of all physicians enrolled in PECOS, updated bimonthly. (This is a large 40MB PDF file, expect a 3-5 minute download time.)
- Use the online PECOS system to look for your enrollment record. If no record is displayed, you do not have an enrollment record in PECOS.
If you have trouble accessing your contact PECOS directly.
- Contact Texas' Medicare contractor Trailblazer at 866-539-5596.
Log in to the site using your National Plan and Provider Enumeration System (NPPES) web user account. If you do not already have an NPPES account, visit the NPPES website to register. (Note: If you have an NPI number, you automatically have an NPPES account.) If you do not have your password, call (866) 484-8049 and select option #6 to have your password reset or e-mail customerservice@npienumerator.com.
CMS has a registration user’s guide (PDF) for the registration and attestation system.
Before you can proceed with the attestation process, you will be prompted for a certification ID. This number is a unique identifier assigned to each certified EHR (see step 5).
Step 5: Visit the Certified Health IT Product List (CHPL) to obtain your unique CMS EHR Certification ID
Choose your EHR, add to cart and press “Get CMS EHR Certification ID.” View the CHPL user guide (PDF) for more detailed instructions.
Step 6: Complete reporting and attestation
Once you have successfully completed 90 days of meaningful use, log back on to the CMS Registration and Attestation website to enter attestation data. If you have not successfully met each required measure, you will be required to resubmit.
Want to make sure you've successfully met each meaningful use measure before officially attesting? Use CMS' Meaningful Use Attestation Calculator. You can print out the final result of each measure, but it may be helpful to record numerator and denominator data to use again for official attestation by using the Attestation Worksheet for Eligible Professionals.
Step 7: Incentive Payment
During the first year of the program, you need to reach $24,000 in Medicare allowable part B charges to be eligible for the maximum incentive of $18,000 (75 percent of total allowable charges). Once you’ve completed the above steps and reached $24,000 in part B charges, you can expect to receive payment from CMS within approximately 6 weeks. If you do not reach $24,000 over the course of the year, CMS will pay 75 percent of total part B charges for the calendar year.
Need on-site technical consulting help to get you to meaningful use? You don’t have to go on this journey alone. If you are a primary care physician, federal subsidies are available through the Texas Regional Extension Centers (REC). The REC can offer assistance if you are looking to select and implement an EHR in your practice, or if you are an existing EHR user looking to optimize your workflow and reach meaningful use.
Call CMS at (888) 734-6433 to find out registration status, attestation status, payment info and progress towards meeting the $24,000 threshold for Medicare Part B.
For more information on the Federal EHR Incentive program contact Texas Medical Association’s Department of Health Information Technology at (800) 880-5720 or HIT@texmed.org.