e-Prescription

How will my e-prescribing be measured?

As it stands currently, CMS will measure participation through the billing codes submitted to Medicare. After a Medicare patient visit, on the Superbill submit, one of the CPT E/M service codes indicate that an ambulatory office visit occurred: 90801-9; 90862; 92002; 92004; 92012; 92014; 96150-2; 99201-5; 99211-5; 99304-10; 99315-16; 99341-5; 99347-50;G0101; G0108-9.

Next check “G8553,” which indicates that at least one prescription created during the visit was generated and transmitted electronically using a qualified electronic prescribing system.

How do I report my e-prescribing activity?

Between now and June 30, 2012, report the e-prescribing G-code G8553 at least 10 times for Medicare office visits or services on Medicare Part B claim forms.

For eligible physicians and group practices using the claims-based reporting mechanism, all claims for services administered between January 1, 2012, and June 30, 2012, need to be received and processed by the Center for Medicare & Medicaid Services (CMS) no later than one month after the June 30th deadline.

Do I receive any incentives if I meet e-prescribing requirements?

Eligible providers who write 25 Medicare e-prescriptions prior to December 31st, 2012, will receive a 1% bonus on Medicare reimbursements in 2013 and will avoid a 2% Medicare payment reduction in 2014.

What are the penalties for failing to e-prescribe?

According to the Medicare Improvements for Patients and Providers Act (MIPPA) eligible physicians who delay utilization of e-prescribing technology past June 30, 2012, will be penalized up to 1.5% of 2013 Medicare reimbursement.

What are the e-prescribing requirements, according to MIPPA?

Eligible providers must write e-prescriptions for 10 unique Medicare patient encounters by June 30th, 2012, in order to avoid 1.5% reduction on Medicare payments in 2013.

Does this bill apply to me?

If E&M services account for more than 10% of the practice’s annual total allowed Medicare charges, the practice is eligible for incentives and penalties based on total Part B payments, not just E&M.