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The Medicare EHR Incentive Program
- The Medicare EHR Incentive Program provides incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.
- Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There’s an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HSPA).To get the maximum incentive payment, Medicare eligible professionals must begin participation by 2012.
The Medicaid EHR Incentive Program
- The Medicaid EHR Incentive Program provides incentive payments to eligible professionals, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.
- Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program
- The Medicaid EHR Incentive Program is voluntarily offered by 43 individual states and territories, and more states will begin offering the program in 2012. Check with your State Medicaid Agency for more information.
Meaningful Use – Simplified
Find Out If Your Eligible
What is an EHR?
An electronic health record (EHR)—sometimes called an electronic medical record (EMR)—allows healthcare providers to record patient information electronically instead of using paper records. However, EHRs are often capable of doing much more than just recording information. The EHR Incentive Program asks providers to use the capabilities of their EHRs to achieve benchmarks that can lead to improved patient care.
The EHR Incentive Program is NOT a reimbursement program for purchasing or replacing an EHR. Providers have to meet specific requirements in order to receive incentive payments.
Choosing a Program: Medicare or Medicaid?
The EHR Incentive Programs are available for Medicare and Medicaid eligible professionals, eligible hospitals, and critical access hospitals (CAHs). Although most hospitals will be able to receive a payment from both programs, eligible professionals must choose which program they want to participate in. The two programs are similar in many ways, but there are some important differences between them. Click on the links below to learn more about the Medicare or Medicaid EHR Incentive Programs.
|Medicare EHR Incentive Program||Medicaid EHR Incentive Program|
|Run by CMS||Run by Your State Medicaid Agency|
|Maximum incentive amount is $44,000||Maximum incentive amount is $63,750|
|Payments over 5 consecutive years||Payments over 6 years, does not have to be consecutive|
|Payment adjustments will begin in 2015 for providers who are eligible but decide not to participate||No Medicaid payment adjustments|
|Providers must demonstrate meaningful use every year to receive incentive payments.||In the first year providers can receive an incentive payment for adopting, implementing, or upgrading EHR technology. Providers must demonstrate meaningful use in the remaining years to receive incentive payments.|
Who Is Eligibile to Participate?
Click on our eligibility tool below to learn whether you are eligible to receive an incentive payment under either the Medicare or Medicaid EHR Incentive Programs—or scroll down to learn more. (To learn which hospitals are eligible to participate in the program, visit our Eligible Hospital Information page.)
Eligibility Requirements for Professionals:
- Incentive payments for eligible professionals are based on individual practitioners.
- If you are part of a practice, each eligible professional may qualify for an incentive payment if each eligible professional successfully demonstrates meaningful use of certified EHR technology.
- Each eligible professional is only eligible for one incentive payment per year, regardless of how many practices or locations at which he or she provides services.
- Hospital-based eligible professionals are not eligible for incentive payments. An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient (Place Of Service code 21) or emergency room (Place Of Service code 23) setting.
|Eligible professionals under the Medicare EHR Incentive Program include:||Eligible professionals under the Medicaid EHR Incentive Program include:|
|Doctor of medicine or osteopathy||Physicians (primarily doctors of medicine and doctors of osteopathy)|
|Doctor of dental surgery or dental medicine||Nurse practitioner|
|Doctor of podiatry||Certified nurse-midwife|
|Doctor of optometry||Dentist|
|Chiropractor||Physician assistant who furnishes services in a Federally Qualified Health Center of Rural Health Clinic that is led by a physician assistant.|