How Can EPs Earn Maximum EHR Incentives?

Medicare Participation Thresholds vs. Patient Encounters for Measures

Every webinar, conference call, FAQ site, or provider forum I attend these days seems to expose the confusion on what the EP has to meet to obtain the maximum amount of money and what they have to attest to prove they are meaningful users. These are not the same thing and one has nothing to do with the other.

Eligible Professionals (EPs) participating in the Medicare EHR Incentive Program for 2011 can receive a payment based on 75% of their total Medicare allowed charges submitted no later than two months after the end of the 2011 calendar year. In other words, the amount will be calculated from your allowed services billed to Medicare Part B (MPFS) for 2011. You have until the end of February 2012 to bill service dates of 2011. The maximum allowed charges used FOR a 2011 incentive payment is $24,000, which means that the maximum incentive payment an EP can RECEIVE for the first participation year is $18,000. If you begin participation in 2012 the calculation is the same but it will be based on your allowed charges billed to Medicare Part B for 2012.

So that is how you will determine how much money you will receive when participating in the MEDICARE incentive program. It has nothing to do with actually receiving the money. To receive incentive money you must register, achieve meaningful use of a certified EHR technology, and then attest to achieving the meaningful use for a period of 90 consecutive days.

To achieve stage 1 meaningful use you will implement your certified system and complete objectives that have specific measures for a designated 90 consecutive days. Many of the measures are based on patient encounters. These patient encounters have nothing to do with Medicare patients. The patient encounters are based on all your patients no matter what payer they come from.

To conclude, the dollar amount of the incentive payment is based on a calendar year of allowed billable charges to Medicare Part B. The actual incentive payment can only be received if you attest to being a meaningful user of certified technology during a consecutive 90 days of that calendar year.

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