Electronic Prescribing Incentive Program


It’s as easy as 1-2-3 to receive your Medicare incentive dollars by following three easy steps…

  1. Purchase a qualified E-prescribing system like Rcopia from DrFirst.
  2. Add G8553 to your Superbill as a cpt code.
  3. Bill G8553 for at least 25 unique electronic prescribing events.

Because of the well documented cost and safety benefits of e-prescribing, CMS has made recent alterations to the Electroinc Prescribing Incentive Program to ensure e-prescribing software is adopted by as many eligible professionals as possible.  See below for specific changes being implemented for 2010:

  • There is only one G-code (G8553) to show a visit resulted in an e-prescription.
  • Providers are only required to enter the new G-code 25 times during the calendar year.
  • In addition to claims-based reporting, any Registry or EHR which has qualified for 2010 PQRI may be used for reporting.
  • The incentives are now extended to professional services furnished in skilled nursing facilities, domiciliary care, and the home care setting.

How are electronic prescriptions counted when reporting the Electronic Prescribing (E-Rx) Incentive Program?

Instances of E-Rx on Medicare Part B eligible patient encounters are counted to determine successful reporting under E-Rx.

Depending on the reporting mechanism selected, please refer to the measure specifications for reporting individual claims and registry, EHR, or Group Practice Reporting Option (GPRO).

Additional  criteria for successful reporting are included in each measure specification.

Claims-based reporting example:  Medicare Part B patient A sees Dr. X for an office visit on January 14.  Dr. X generates and transmits 3 E-Rx prescriptions.  Dr. X bills encounter code 99215 and submits quality-data code (QDC) G8553 on the claim.  Even though Dr. X generated and transmitted e E-Rx prescriptions, this would count as one (1) instance of E-Rx reporting.  If patient A returns to see Dr. X January 28 AND Dr. X generates and transmits 2 E-Rx prescriptions, bills 99212, and submits QDC G8553 on the claim, this would count as one (1) instance of E-Rx reporting.

Note that Patient A does not have to be a unique patient to report E-Rx again.  In this example, Dr. X satisfied 2 eligible instances of reporting the E-Rx measure for the E-Rx Incentive Program.


Practices can earn a bonus equal to 2% of their annual Medicare billings per provider in 2010.  In 2012, practices that have not adopted e-prescribing will be penalized by a 0.5% decrease in Medicare reimbursements that escalate into a 1.5% penalty in 2014 and beyond until the provider adopts a certified e-prescribing system.

One response to “Electronic Prescribing Incentive Program

  1. Pingback: Two Important Meaningful Use Stage 2 Requirements! | Medical Mastermind

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