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On Tuesday, November 8, 2011 CMS held a National Provider Call to provide updates on the 2012 Physician Fee Schedule Final Rule, Quality Reporting Initiatives. Details on these updates are listed below.
- eRx incentive amounts are based on a provider’s total Medicare allowed amount for the calendar year. Going forward these payments will be:
- eRx payment adjustment amounts, also based on provider’s total Medicare allowed amount for the calendar year, will be :
- 2012: 1.0%
- 2013: 1.5%
- 2014: 2.0%
- There are no incentives or payment adjustments scheduled past 2014. The eRx program will end after 2014 due to EHR program participation requirements.
- Highlights of changes for the 2012 program year include:
- 6-month reporting period (January 1 thru June 30, 2012 and 2013) will allow eligible professionals to report the eRx numerator code G8553 at least 10 times on any service to avoid future payment adjustments.
- To receive incentive payments, eRx numerator code G8553 must be reported at least 25 times for encounters associated with at least one of the denominator eligible CPT codes during the 12-month reporting period of January 1 thru December 31, 2012 and 2013.
- Significant Hardships Exemptions:
- The eligible professional or group practice is in a rural area with limited high-speed Internet access
- The eligible professional or group practice is in an area with limited available pharmacies for electronic prescribing
- Inability to electronically prescribe due to local, state, or federal law or regulation
- Eligible professionals who prescribe fewer than 100 prescriptions during a 6-month payment adjustment reporting period
- Deadline to submit requests for significant hardship exemption is June 30, 2012.
- Method of submission is CMS Communication Support Page