Medical providers are currently being bombarded with various incentive and penalty programs… from PQRS, to EMR incentives, the sequestration cuts, and e-Rx. Of all of these programs, e-prescribing is on the easier end for provider participation. If your practice is not currently e-prescribing, what are you waiting for? With the correct software (often free, or available at little expense), and the proper coding and billing of an eRX CPT, providers can avoid an unnecessary 2% cut in their Medicare payments. Aside from the financial incentive, e-prescribing also provides a service to patients, and may increase the ease and accuracy of your prescription process. The June 30th deadline for reporting eRx codes is fast approaching — don’t let your payments get cut!
Please see the below message, taken directly from CMS’ Medicare FFS Provider e-News for Thursday, May 2, 2013:
June 30 Deadline to Avoid 2014 eRx Payment Adjustment
In CY 2014, a payment adjustment will be applied to an eligible professional’s or group practice’s (if participating in the Electronic Prescribing (eRx) Group Practice Reporting Option (GPRO)) Medicare Part B Physician Fee Schedule (PFS) covered professional services for not becoming a successful electronic prescriber. The payment adjustment of 2.0% will result in an eligible professional or group practice participating in eRx GPRO receiving 98.0% of their Medicare Part B PFS amount for covered professional services in 2014. Please note that this message only applies to the 2014 eRx payment adjustment. The reporting period to avoid or submit hardship exemptions for the 2012 and 2013 eRx payment adjustments has ended.
Exclusion Criteria
The 2014 eRx payment adjustment only applies to certain individual eligible professionals and group practices. CMS will automatically exclude those individual eligible professionals and group practices who meet the criteria listed in the Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.
Avoiding the 2014 eRx Payment Adjustment
Individual eligible professionals and CMS-selected group practices participating in eRx GPRO who were not successful electronic prescribers in 2012 can avoid the 2014 eRx payment adjustment by meeting the specified reporting requirements between January 1 and June 30, 2013. The 6-month reporting requirements to avoid the 2014 payment adjustment are as follows:
- Individual Eligible Professionals – 10 eRx events via claims
- eRx GPRO of 2-24 Eligible Professionals – 75 eRx events via claims
- eRx GPRO of 25-99 Eligible Professionals – 625 eRx events via claims
- eRx GPRO of 100+ Eligible Professionals – 2,500 eRx events via claims
Significant Hardships
CMS may exempt individual eligible professionals and group practices participating in eRx GPRO from the 2014 eRx payment adjustment if it is determined that compliance with the requirements for becoming a successful electronic prescriber would result in a significant hardship. The significant hardship categories are also listed in the Electronic Prescribing (eRx) Incentive Program: 2014 Payment Adjustment Fact Sheet.
