Meaningful Use
Medicare EHR Incentive Payments
Under FFS Medicare, the payment incentive amount, subject to an annual limit, is equal to 75 percent of an EP’s Medicare physician fee schedule allowed charges submitted not later than 2 months after the end of the calendar year. This means that, for 2011, the EHR incentive payment for an EP would be, subject to an annual limit, equal to 75% of the EP’s Medicare physician fee schedule allowed charges for CY 2011, based on claims for services performed by the EP from January 1, 2011 through December 31, 2011, and submitted to the EP’s Medicare contractor (MAC/carrier) no later than February 29, 2012.
Calendar Year |
Maximum Incentive Payments |
Maximum Incentive Payments |
Maximum Incentive Payments |
Maximum Incentive Payments |
---|---|---|---|---|
2011 | 2012 | 2013 | 2014 | |
2011 | $18,000 | |||
2012 | $12,000 | $18,000 | ||
2013 | $8,000 | $12,000 | $15,000 | |
2014 | $4,000 | $8,000 | $12,000 | $12,000 |
2015 | $2,000 | $4,000 | $8,000 | $8,000 |
2016 | $2,000 | $4,000 | $4,000 | |
Total | $44,000 | $44,000 | $39,000 | $24,000 |
Medicaid EHR Incentive Payment
Incentive Payment - Volume Requirements
To be eligible to participate in the Medicaid EHR Incentive Program, an EP must either: (1) Meet certain Medicaid patient volume thresholds or (2) practice predominantly in an FQHC or RHC where 30 percent of the patient volume is derived from needy individuals. One exception to this rule is that a pediatrician may have at least 20 percent Medicaid patient volume and still qualify but at a reduced incentive.
Calendar Year |
Maximum Incentive Payments |
Maximum Incentive Payments |
Maximum Incentive Payments |
Maximum Incentive Payments |
---|---|---|---|---|
2011 | 2012 | 2013 | 2014 | |
2011 | $21,250 | |||
2012 | $8,500 | $21,250 | ||
2013 | $8,500 | $8,500 | $21,250 | |
2014 | $8,500 | $8,000 | $8,500 | $21,250 |
2015 | $8,500 | $8,500 | $8,500 | $8,500 |
2016 | $8,500 | $8,500 | $8,500 | $8,500 |
2017 | $8,500 | $8,500 | $8,500 | |
2018 | $8,500 | $8,500 | ||
2019 | $8,500 | |||
Total | $63,750 | $63,750 | $63,750 | $63,750 |
Incentive Payment - Patient Volume Calculation
The Medicaid patient volume methodology will be designated by the State Medicaid Agency and approved by CMS. Note: The final rule describes acceptable methods for estimating patient volume. In determining patient volume thresholds, EPs should include individuals enrolled in Medicaid managed care organizations, prepaid inpatient health plans, prepaid ambulatory health plans, and Medicaid medical home programs or Primary Care Case Management.