EHR Incentive Program Blog Series Part V: Eligibility

Before you take any steps, make sure you are eligible for the program. For the Medicare EHR Incentive Program, only “eligible professionals” can participate. Eligible professionals include doctors of medicine or osteopathy, doctors of dental surgery or dental medicine, doctors of podiatry, doctors of optometry, and chiropractors. Please note, because incentive payments are made to individual providers, practices are not eligible to participate. However, a provider can designate a practice to receive the incentive funds on their behalf. It is up to the provider to make this decision and the practice or medical group cannot claim the money or make the decision for the provider, even if the EHR belongs to the practice. Additionally, hospital-based providers cannot participate .

For the Medicaid EHR Incentive Program, eligible professionals include physicians, nurse practitioners, certified nurse-midwives, dentists, physician assistants (who furnish services in a Federally Qualified Health Center or Rural Health Clinic that is lead by a physician assistant). Certain states allow for optometrists to be eligible. For an optometrist to be eligible, the state Medicaid program must cover adult optometrist services as physician services in the Medicaid State Plan. Check with your state Medicaid agency for more information.

Further, an eligible professional must also meet certain criteria:

  • Have a minimum 30% Medicaid patient volume
  • Have a minimum 20% Medicaid patient volume, and be pediatrician
  • Practice predominantly in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) and have a minimum 30% patient volume attributable to needy individuals

Click here for more information from CMS regarding eligibility.

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One thought on “EHR Incentive Program Blog Series Part V: Eligibility

  1. Pingback: Monday Morning Recap | hmsabc

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