Participate in the Medicaid EHR Incentive Program by 2016

Physicians interested in receiving incentives for participation in the Medicaid electronic health record (EHR) incentive program need to begin by adopting, implementing, or upgrading a certified EHR by 2016. It is the last year physicians may begin participation in the program to qualify for an incentive, which pays out until 2021. 

Non-hospital-based eligible professionals with at least 30 percent Medicaid volume could receive up to $63,750 over a six-year period.

  Year 1 Year 2 Year 3 Year 4 Year 5 Year 6
Adopt, implement, or upgrade a certified EHR $21,250  
Successfully attest to meaningful use program requirements   $8,500 per year for the next five years

Non-hospital-based eligible pediatricians with at least 20 percent Medicaid volume could receive up to $42,500 over a six-year period.

  Year 1 Year 2 Year 3 Year 4 Year 5 Year 6
Adopt, implement, or upgrade a certified EHR $14,167  
Successfully attest to meaningful use program requirements   $5,667 per year for the next five years

To qualify, physicians must meet the volume requirements each year. When calculating the volume, physicians must choose a sample 90-day period from the year prior to participation. Therefore, you must meet the Medicaid volume requirement in 2015 to participate in 2016. 

In the first year, participants receive the incentive payment for adopting, implementing, or upgrading a certified EHR. In all remaining years, participants must meet meaningful use requirements, just like the Medicare program. Physicians who already are participating in the Medicare EHR incentive program may not switch to the Medicaid program.

Texas Medicaid eligible professionals (EPs) must be enrolled as performing or billing providers to participate in the EHR incentive program. The enrollment process can be lengthy and may take up to 60 days to complete. If you do not initiate the enrollment process early by completing and submitting the Texas Medicaid Provider Enrollment Application, you may not receive your Medicaid provider credentials in time to meet EHR program deadlines. If you already are enrolled, make sure all credentials are up to date. Read this article from Texas Medicaid & Healthcare Partnership for additional information on the Medicaid enrollment requirements for the EHR incentive program.

For additional assistance with the Texas Medicaid EHR Incentive Program, email HealthIT[at]tmhp[dot]com, or call the Contact Center at (800) 925-9126 (option 4).

For more information about meaningful use, contact the TMA Health Information Technology Department by phone at (800) 880-5720 or by email.

Action, July 15, 2015

Last Updated On

July 15, 2015

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