Who is eligible for 2012 ERX incentive

2012 Electronic Prescribing (eRx) Payment Adjustment: Assessment and Application


An eligible professional was included in the 2012 eRx payment adjustment analysis if  they meet all of the following criteria:

• Was a physician (MD, DO, or podiatrist), Nurse Practitioner, or Physician Assistant as of June 30, 2011, based on primary taxonomy code in the National Plan and Provider Enumeration System (NPPES);

• Had prescribing privileges from 1/1/11-6/30/11;

• Had at least 100 cases containing an encounter code in the measure’s denominator from 1/1/11-6/30/11; AND

• Had 10% or more of their Medicare Part B allowable charges (per Tax Identification Number (TIN)) from 1/1/11-6/30/11 were for encounter codes in the measure’s denominator

Eligible professionals were automatically excluded from the 2012 eRx payment adjustment analysis if they did NOT meet one of the above criteria. In addition, eligible professionals could have taken the following steps from to avoid the 2012 eRx payment adjustment:

• Submitted 10 or more 2011 eRx quality-data codes (G8553) for Medicare Part B PFS services via claims from 1/1/11-6/30/11;

• Indicated that the eligible professional met criteria for a hardship exemption for either living in a rural area without sufficient high speed internet (G8642), or practiced in an area without sufficient pharmacies that can accept eRx (G8643) via claims from 1/1/11-6/30/11;

• Indicated that the eligible professional did not have prescribing privileges (G8644) via claims from1/1/11-6/30/11; OR

• Requested a hardship exemption via the Quality Reporting Communication Support Page on or before 11/8/11, and received CMS approval.

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