How do I get paid for the Electronic Health Record (EHR) Incentive Programs?

Payments for the Medicare and Medicaid EHR Incentive Programs are distributed based on each year of participation, and follow a specific payment schedule. Located below are payment details on the Medicare and Medicaid EHR Incentive Programs. For an overview, see the Medicare Learning Network (MLN) Matters Special Edition article (SE1111) – Medicare Electronic Health Record (EHR) Incentive Payment Process.

Medicare EHR Incentive Program
• Eligible professionals (EPs): EPs can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There’s an additional incentive for EPs who provide services in a Health Professional Shortage Area (HPSA).To get the maximum incentive payment, Medicare EPs must begin participation by 2012.
• Eligible hospitals and critical access hospitals (CAHs): Incentive payments to eligible hospitals and CAHs may begin as early as 2011, and are based on a number of factors, beginning with a $2 million base payment.

Medicaid EHR Incentive Program
• EPs: The Medicaid EHR Incentive Program is voluntarily offered by states and territories. EPs can receive up to $63,750 over the six years that they choose to participate in the program. Medicaid EPs must initiate the program by 2016.
• Eligible hospitals: Medicaid hospitals that qualify for incentive payments may begin receiving incentive payments as early as FY 2011. Hospital payments are based on a number of factors, beginning with a $2 million base payment. Medicaid hospitals must initiate the payments by 2016.

IMPORTANT NOTE: Medicare Administration Contractors (MACs), carriers, and Fiscal Intermediaries (FIs) will not be making Medicare EHR incentive payments. CMS has contracted with a Payment File Development Contractor to make these payments.
DON’T: Call your MAC/Carrier/FI with questions about your EHR incentive payment.

INSTEAD: Call the EHR Information Center
• Hours of Operation: 7:30 a.m. – 6:30 p.m. (Central Time) Monday through Friday, except federal holidays.
• 1-888-734-6433 (primary number) or 888-734-6563 (TTY number).
A revised FAQ on payment for the EHR Incentive Programs has been posted to the EHR website

Question: For the 2011 payment year, how and when will incentive payments for the Medicare EHR Incentive Program be made?

Answer: For EPs, incentive payments for the Medicare EHR Incentive Program will be made approximately four to eight weeks after an EP successfully attests that they have demonstrated meaningful use of certified EHR technology. However, EPs will not receive incentive payments within that timeframe if they have not yet met the threshold for allowed charges for covered professional services furnished by the EP during the year. Read the rest of the answer to this FAQ here.

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