The Official Web Site for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs

ehr

The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.

Here are some important 2014 EHR participation dates to keep in mind:

  • March 31, 2014 at 11:59 pm ET: Attestation deadline for Medicare eligible professionals for the 2013 program year
  • September 30: End of 2014 fiscal year and end of the 2014 reporting period for eligible hospitals
  • November 30, 2014 at 11:59 pm ET: Attestation deadline for Medicare eligible hospitals for the 2014 program year
  • December 31: End of 2014 calendar year and end of the 2014 reporting period for eligible professionals

Eligible hospitals and critical access hospitals (CAHs) should visit our Eligible Hospital Information page to learn about the EHR Incentive Programs

Sequestration and the Medicare and Medicaid EHR Incentive Programs

Incentive payments made through the Medicare Electronic Health Records (EHR) Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011. The American Taxpayer Relief Act of 2012 postponed sequestration for 2 months. As required by law, President Obama issued a sequestration order on March 1, 2013. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%. This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.

Please note that this reduction does not apply to Medicaid EHR incentive payments, which are exempt from the mandatory reductions.

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.

The EHR Incentive Program provides incentive payments for eligible healthcare providers to use EHR technology in ways that can positively impact patient care

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 Eligible 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.

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.