For those who have attested and are participating in the stimulus incentives, this is included with an integrated electronic medical record system and thus so the penalty of 2% less really stands to impact those doctors who are still using paper records, unless they did participate in the CMS program and submitted the number of claims needed(25 to avoid 2015 penalty and 10 for 2014 penalty) showing that CPT code that an e-prescription was generated.
G8553 is the CPT code that is required on a claim to show that a qualified e-prescribing system was used. Incentives started a few years ago for being an early user and some made some additional incentive money there but now we are at the other end to where penalties kick in. Last year the penalty for non e-prescribers was 1.5% penalty adjustment on Medicare Part B and this year it’s growing to 2% and from what CMS has published unless that changes, which it could down the road with new rules, it appears 2% penalty is the number to live with.
A full description and pdf fact sheet from CMS can be found here. BD
Individual eligible professionals and group practices participating in the eRx Group Practice Reporting Option (GPRO) who are not successful electronic prescribers will be subject to a 2.0% payment adjustment on their Medicare Part B services provided January 1, 2014 through December 31, 2014.
To avoid the 2014 eRx payment adjustment, individual eligible professionals would have had to have been a successful electronic prescriber in 2012 or will need to report the G8553 code via claims for at least 10 billable Medicare Part B PFS services provided January 1, 2013 through June 30, 2013. Please review the factsheet titled "2013 eRx Incentive Program: 2014 Payment Adjustments" on the "Payment Adjustment Information" section page to the left for more detailed information, including how an eligible professional or group practice can quality and request a hardship exemption to the 2014 eRx payment adjustment.
Individual eligible professionals and group practices participating in the eRx Group Practice Reporting Option (GPRO) who are not successful electronic prescribers will be subject to a 1.5% payment adjustment on their Medicare Part B services provided January 1, 2013 through December 31, 2013.
To avoid the 2013 eRx payment adjustment, individual eligible professionals would have had to have been a successful electronic prescriber in 2011, reported the G8553 code via claims for at least 10 billable Medicare Part B PFS services provided January 1, 2012 through June 30, 2012 or approved for a significant hardship exemption.
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