Incorporating electronic prescribing (ePrescribing) into your practice helps assure that every script you write is accurate, error-free and understandable to pharmacists, thus improving patient care. The Centers for Medicare and Medicaid Services’ (CMS) E-Prescribing Incentive Program, initiated in January 2009, encourages e-prescribing but can also ensure a positive return on investment for your medical practice to purchase and use the technology.
The CMS program offers a bonus payment equal to two percent of Medicare physician fee schedule allowed charges for eligible professionals who use qualified e-prescribing systems. The spectrum of eligible providers is wide – from physicians to physical therapists. In addition to being an eligible provider, at least 10 percent of your Medicare allowed charges must be comprised of the 55 codes that CMS specifies as “denominator codes” in order to qualify for the incentive program. The designated codes are primarily office visit codes but also include nursing home, home health and psychiatric care. In order to participate, you need to use a qualified e-prescribing system that is capable of electronically recording and tracking the patient’s prescription formulary, history and fill status.
How it works
Eligible providers, who qualify based on profession, meet the 10 percent rule and are using a qualified system, must report an e-prescribing measure to CMS at least 25 times for unique patient visits between January 1 and December 31, 2010. A provider, however, can report on the same patient more than once. When you see a Medicare patient for one of these codes, you must submit the G8553 code – “at least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx system” – just as you would any other service on your CMS 1500 claim.
There’s no registration process or enrollment form to submit to demonstrate your interest. Once you have e-prescribing technology and processes in place, you can begin.
There are two downsides, but both are relatively small. First, don’t expect a bonus check in the mail next week; CMS reports that those taking part in the 2009 program won’t receive feedback reports and checks until mid-year 2010. It may be the same for subsequent years of the program. The other downside is that CMS doesn’t offer a means for you to check progress through the year.
Two percent of total allowed Medicare charges are on the table in 2010 for successful E-Prescribing Incentive Program participants. While not a huge bonus, it’s not a bad return considering that all you’ve got to do is submit one code – G8553 – 25 times.
The time to participate is now: this is the final year for the CME E-Prescribing Incentive Program’s bonus at the full 2 percent level. CMS is phasing out the bonus – it drops to 1 percent for 2011 and 2012, and to 0.5 percent for 2013. Although the E-Prescribing Incentive Program is not required, providers who decide not to participate will see their Medicare fee schedule drop by 1 percent in 2012, 1.5 percent in 2013, and 2 percent in 2014.
Consider also that e-prescribing is one of the final 25 proposed criteria for “meaningful use” in the government’s EHR bonus payment program, which begins next year.
Take advantage of the opportunities offered by the CMS’ E-Prescribing Incentive Program: it will help improve patient quality and safety, jumpstart your practice for the EMR bonus program and provide much needed revenue to your practice.
Note: As you may know, today ePrescribing of controlled substances is not allowed by Federal law. However, last week the Drug Enforcement Administration (DEA) published a Request for Comments on a proposed rule which will enable ePrescribing of controlled substances. Until this interim final rule has been passed into law, ePrescribing of controlled substances remains disallowed.
For more information on the ePrescribing Incentive visit: http://www.cms.hhs.gov/ERxIncentive/06_E-Prescribing_Measure.asp
Ready to get started?
Sage has two options to help you get started with ePrescribing. If you’re looking for a full EHR, take a look at Sage Intergy EHR’s robust features for ePrescribing, Drug Utilization Review, guideline-driven care and more. Or, if you’re looking for a stand-alone solution, consider Sage ePrescribe.
