E-prescribe in 2011 to Avoid 2012 Penalty

To avoid penalties in 2012 (1 percent of Medicare Part B claims), TMA recommends all physicians report e-prescribing via claims on at least 10 unique Medicare encounters by June 30, 2011 and report at least 25 unique Medicare encounters during the full 2011 year to qualify for the 2011 incentive (1 percent of Medicare Part B claims).

The Centers for Medicare & Medicaid Services (CMS) has offered the e-prescribing incentive since 2009 to encourage the use of e-prescribing to improve the efficiency and safety of health care. E-prescribing is a way to prevent medication errors that arise due to difficulties in reading or understanding handwritten prescriptions.    






1 percent

1 percent

0.5 percent




1 percent

1.5 percent

2 percent



If you plan to apply for the Medicare EHR incentive in 2011, note that you can't receive the e-prescribing incentive in the same year. Physicians enrolled in the federal Medicare EHR incentive program can still be penalized in 2012 if they do not report 10 e-prescriptions via claims method using G-code G8553. Part of the “meaningful use” criteria set for the federal EHR incentives requires e-prescribing.

Physicians applying for the Medicaid EHR incentive are still eligible for e-prescribing incentive payments.  

What type of encounter will count as an event?  
A physician must generate at least one electronic prescription using a qualified system during a patient visit from a set of defined services. Multiple prescriptions to the same patient will constitute only one event. 

How do I report e-prescribing data?
To avoid the penalty in 2012, physicians must report by using G-code G8553 on claims. The incentive, however, gives physicians three options for reporting data.

  • Claims-based reporting of the eRx measure. Report only one G-code (G8553) for 2011.
  • Registry-based reporting using a "CMS-selected" registry to submit 2011 data to CMS.
  • EHR-based reporting using a "CMS-selected" EHR product, submitting 2011 data to CMS.

Read TMA's 2011 E-Prescribing Incentive Requirements White Paper [PDF] for more detailed program information.

Visit the "Getting Started" webpage on the CMS website for more information. CMS also maintains lists of qualified e-prescribing registries [PDF] and qualified EHR vendors [PDF]

Do you need technical consulting help? The Texas regional extension centers support primary care physicians with individualized on-site services, technical assistance, guidance, and ongoing support.  Visit  TMA's Texas REC Resource Center for more information.

Action, Feb. 15, 2011