Medicare and Medicaid EHR Incentive Programs Flow Chart to Help Eligible Professionals (EPs) Determine Eligibility for the...
Introduction <ul><li>A Medicaid EP may also qualify for the Medicare incentive  </li></ul><ul><li>An EP who qualifies for ...
Service Setting <ul><li>Did you perform 90% of your services in an inpatient hospital or emergency room hospital setting? ...
Medicaid <ul><li>Were at least 30% of your services furnished to Medicaid* patients?** (20% requirement for pediatricians)...
FQHC or RHC <ul><li>Did you practice predominantly* in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (...
Medicaid EPs <ul><li>Are you one of the following? </li></ul><ul><ul><li>Physician* </li></ul></ul><ul><ul><li>*Physicians...
Medicaid EPs <ul><li>Are you one of the following? </li></ul><ul><ul><li>Physician* *Physicians in the Medicaid program ar...
Medicare <ul><li>Do you treat Medicare patients and bill for Part B services on the Medicare Physician Fee Schedule? </li>...
Medicare EPs <ul><li>Are you one of the following? </li></ul><ul><ul><li>Doctor of medicine or osteopathy </li></ul></ul><...
Eligibility Result <ul><li>If you adopt, implement or upgrade to or successfully demonstrate meaningful use of certified E...
Eligibility Result <ul><li>If you adopt, implement or upgrade to or successfully demonstrate meaningful use of certified E...
Eligibility Result <ul><li>If you successfully demonstrate meaningful use, you may be eligible to receive an incentive pay...
Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid E...
Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid E...
Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid E...
Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid E...
Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid E...
For More Information <ul><li>http://www.cms.gov/EHRIncentivePrograms </li></ul><ul><li>Follow us on Twitter at  http://www...
Upcoming SlideShare
Loading in …5
×

EHR Ep Decision Tool

505 views
419 views

Published on

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
505
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
11
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

EHR Ep Decision Tool

  1. 1. Medicare and Medicaid EHR Incentive Programs Flow Chart to Help Eligible Professionals (EPs) Determine Eligibility for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs Centers for Medicare & Medicaid Services Next
  2. 2. Introduction <ul><li>A Medicaid EP may also qualify for the Medicare incentive </li></ul><ul><li>An EP who qualifies for both programs may only participate in one program </li></ul><ul><li>EPs who qualify for EHR incentive payments under Medicare or Medicaid will maximize their payments by choosing the Medicaid EHR Incentive Program. </li></ul>Begin Back
  3. 3. Service Setting <ul><li>Did you perform 90% of your services in an inpatient hospital or emergency room hospital setting? </li></ul>Yes No Back
  4. 4. Medicaid <ul><li>Were at least 30% of your services furnished to Medicaid* patients?** (20% requirement for pediatricians)? </li></ul><ul><li>*To determine eligibility for the Medicare EHR Incentive Program, EPs should follow the path of answering “No” to this question. Please note that an EP who qualifies for both programs may only participate in one program. </li></ul><ul><li>** Medicaid patients might be fee-for-service encounters where the State Medicaid Agency pays you for your services (this includes primary care case management and medical home programs). Also, it might mean that you see patients through a state’s Medicaid managed care program (i.e., you are a network provider for a managed care organization contracted to provide Medicaid services). Please contact your State Medicaid Agency about this and for more information about calculating the patient volume with precision. </li></ul>Yes No Back
  5. 5. FQHC or RHC <ul><li>Did you practice predominantly* in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) with a 30% needy individual** patient volume threshold? *&quot;Practicing Predominantly&quot; means that more than 50% of your clinical services were provided in an FQHC or RHC in a six-month period in the most recent year. </li></ul><ul><li>**“Needy Individuals” include individuals who are: (1) Receiving medical assistance from Medicaid or the Children’s Health Insurance Program (CHIP); (2) Furnished uncompensated care by the provider; or (3) Furnished services at either no cost or reduced cost based on a sliding scale </li></ul>Yes No Back
  6. 6. Medicaid EPs <ul><li>Are you one of the following? </li></ul><ul><ul><li>Physician* </li></ul></ul><ul><ul><li>*Physicians in the Medicaid program are almost always required to be Medical Doctors (MDs) or Doctors of Osteopathy (DOs). </li></ul></ul><ul><ul><li>Dentist </li></ul></ul><ul><ul><li>Certified nurse-midwife </li></ul></ul><ul><ul><li>Nurse practitioner </li></ul></ul><ul><ul><li>Physician assistant practicing in an FQHC or RHC led by a physician assistant </li></ul></ul>Yes No Back
  7. 7. Medicaid EPs <ul><li>Are you one of the following? </li></ul><ul><ul><li>Physician* *Physicians in the Medicaid program are almost always required to be Medical Doctors (MDs) or Doctors of Osteopathy (DOs). </li></ul></ul><ul><ul><li>Dentist </li></ul></ul><ul><ul><li>Certified nurse-midwife </li></ul></ul><ul><ul><li>Nurse practitioner </li></ul></ul><ul><ul><li>Physician assistant practicing in an FQHC or RHC led by a physician assistant </li></ul></ul>Yes No Back
  8. 8. Medicare <ul><li>Do you treat Medicare patients and bill for Part B services on the Medicare Physician Fee Schedule? </li></ul>Yes No Back
  9. 9. Medicare EPs <ul><li>Are you one of the following? </li></ul><ul><ul><li>Doctor of medicine or osteopathy </li></ul></ul><ul><ul><li>Doctor of oral surgery or dental medicine </li></ul></ul><ul><ul><li>Doctor of podiatric medicine </li></ul></ul><ul><ul><li>Doctor of optometry </li></ul></ul><ul><ul><li>Chiropractor </li></ul></ul>Yes No Back
  10. 10. Eligibility Result <ul><li>If you adopt, implement or upgrade to or successfully demonstrate meaningful use of certified EHR technology, you may be eligible to receive an incentive payment under the Medicaid EHR Incentive Program. </li></ul><ul><li>NOTE: EPs who qualify for incentive payments under both the Medicare and Medicaid EHR Incentive Programs will maximize their payments by choosing the Medicaid EHR Incentive Program. </li></ul>Back End
  11. 11. Eligibility Result <ul><li>If you adopt, implement or upgrade to or successfully demonstrate meaningful use of certified EHR technology, you may be eligible to receive an incentive payment under the Medicaid EHR Incentive Program. </li></ul><ul><li>NOTE: EPs who qualify for incentive payments under both the Medicare and Medicaid EHR Incentive Programs will maximize their payments by choosing the Medicaid EHR Incentive Program. </li></ul>Back End
  12. 12. Eligibility Result <ul><li>If you successfully demonstrate meaningful use, you may be eligible to receive an incentive payment under the Medicare EHR Incentive Program. </li></ul><ul><li>NOTE: EPs who qualify for incentive payments under both the Medicare and Medicaid EHR Incentive Programs will maximize their payments by choosing the Medicaid EHR Incentive Program. </li></ul>Back End
  13. 13. Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid EHR Incentive Programs. </li></ul>Back End
  14. 14. Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid EHR Incentive Programs. </li></ul>Back End
  15. 15. Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid EHR Incentive Programs. </li></ul>Back End
  16. 16. Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid EHR Incentive Programs. </li></ul>Back End
  17. 17. Eligibility Result <ul><li>You are NOT currently eligible to receive an incentive payment under the Medicare or Medicaid EHR Incentive Programs. </li></ul>Back End
  18. 18. For More Information <ul><li>http://www.cms.gov/EHRIncentivePrograms </li></ul><ul><li>Follow us on Twitter at http://www.twitter.com/CMSGov </li></ul><ul><li>Press <Esc> to end </li></ul>

×