All Medicare providers (e.g. physicians, NPs, PAs, etc.) are eligible to earn a 0.5 percent incentive on their total Medicare Part B allowed charges by electronically prescribing a total of 25 times from Jan. 1 to Dec. 31, 2013, and reporting this to The Centers for Medicare and Medicaid Services (CMS) through their claims with the code G8553 along with the applicable E/M code*. Please note, you must e-prescribe for a Medicare Part B patient.
Providers who successfully reported this measure in 2012 for an incentive are also exempt from a 2.0 percent penalty in 2014. Additionally, providers who want to avoid a 1.5 percent penalty in 2013 must have reported the measure through their claims at least 10 times between Jan. 1 and June 30, 2012. CMS requires submission of documentation of e-prescribing through claims; providers are not allowed to use a registry or EHR to avoid the penalty in 2013.
Claims-based reporting options to receive the eRx 0.5% incentive for 2013:
*Eligible denominator codes include: 90801, 90802, 90804-90809, 90862, 92002, 92004, 92012, 92014, 96150-96152, 99201-99205, 99211-99215, 99304-99310, 99315, 99316, 99324-99328, 99334-99337, 99341-99345, 99347-99350, G0101, G0108 and G0109.
CMS Electronic Prescribing Program reporting options for avoiding 1.5% penalty in 2013:
| If you | Report | Frequency | Before |
| Successfully attested for meaningful use | Nothing; CMS will automatically exempt you from the penalty in 2013 | N/A | Between Jan. 1, 2011 and June 30, 2012 |
| Registered for the EHR Incentive Program on the CMS website and adopted a certified EHR system | Nothing; CMS will automatically exempt you from the penalty in 2013 | N/A | Between Jan. 2, 2012 and Jan. 31, 2013 |
| Practice in a rural area without sufficient high speed internet access | Attest on an online protal at www.qualitynet.org/portal/
server.pt/community/comm
unications_support_system/
234
You can call the Quality Net
help desk at (866) 288-8912
or email qnetsupport@sdps.org. | 1 time | Jan. 31, 2013 |
| Practice in an area without sufficient access to pharmacies that accept electronic prescriptions |
| Are unable to e-prescribe due to local, state or federal laws (e.g. prescribe mainly narcotics) |
| Prescribe fewer than 100 total prescriptions between Jan. 1 - June 30, 2012 |
CMS Electronic Prescribing Program reporting options for avoiding 2.0% penalty in 2014:
| If you | Report | Frequency | Before |
| Successfully created an electronic prescription | G8553 | 10 times | June 30, 2013 |
| Do not have at least 100 claims containing an E/M code between Jan. 1 - June 30, 2013 | Nothing; CMS will automatically exempt you from the penalty in 2014 | N/A | June 30, 2013 |
| Do not have prescribing authority | G8644 | 1 time | June 30, 2013 |
| Have less than 10 percent of your total allowed charges comprised of E/M codes between Jan. 1 - June 30, 2013 | Nothing; CMS will calculate this and exempt you from the penalty in 2014 | N/A | June 30, 2013 |
| Successfully attested for meaningful use | Nothing; CMS will calculate this and exempt you from the penalty in 2014 | N/A | Between Jan. 1 2012 and June 30, 2013 |
| Registered for the EHR Incentive Program on the CMS website and adopted a certified EHR system | Nothing; CMS will calculate this and exempt you from the penalty in 2014 | N/A | Between Jan. 1, 2013 and June 30, 2013 |
| Practice in a rural area without sufficient high speed internet access | Attest on an online portal at www.qualitynet.org/portal/
server.pt/community/comm
unications_support_system/
234
You can call the Quality Net
help desk at (866) 288-8912
or email qnetsupport@sdps.org | 1 time | June 30, 2013 |
| Practice in an area without sufficient access to pharmacies that accept electronic prescriptions |
| Are unable to e-prescribe due to local, state or federal laws (e.g. prescribe mainly narcotics) |
| Prescribe fewer than 100 total prescriptions between Jan. 1 - June 30, 2013 |
Note: If you plan to participate in the EHR incentive program in 2013, you will not be eligible to collect the 0.5 percent e-prescribing bonus. CMS does not allow physicians to collect both bonuses, however, NPs and PAs are not eligible for the Medicare EHR incentive program, so they can continue collecting the e-prescribing bonus. For more information, visit www.aad.org/hitkit or the CMS website.
| Year | Incentive** | Penalty** |
| 2013 | .5 percent | -1.5 percent |
| 2014 | 0 percent | -2 percent |
**Percentage is based on total Medicare Part B allowed charges.
2013 E-Prescribing Penalty Informal Review Process
CMS began notifying providers in December 2012 if they were eligible to receive the 2013 e-prescribing penalty. If you believe this determination is incorrect, you can file an informal appeal by email to eRxInformalReview@cms.hhs.gov. Please include your individual rendering National Provider Identifier (NPI) as well as your contact information including email address, telephone number, and mailing address as well as justification as to why you are requesting an informal review. Please note eligible professionals should not provide their Tax Identification Number (TIN) via email. Providers have until Feb. 28, 2013 to submit an appeal.
2011 E-Prescribing Incentive Program
CMS began distributing incentive payments in September 2012 to providers who participated in the e-prescribing incentive program in 2011. Providers may visit the Quality Net Portal to access feedback reports explaining their participation in the program.