Definition

e-prescribing (eRx) incentive program

The Electronic Prescribing (eRx) Incentive Program is a US government program that provides financial incentives to physicians, practitioners and therapists who meet certain criteria for the use of qualified e-prescribing systems. 

The incentive amounts to 2% of a group practice's total allowed charges for covered professional services under the Medicare Part B Physician Fee Schedule, according to the Centers for Medicare & Medicaid Services (CMS).

To be eligible, a health care provider should expect that at least 10% of its Medicare Part B charges will be reporting to a particular set of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes. Such reporting should be done for at least 50% of the Medicare Part B patients that the practice saw in that given reporting year. A practice can submit this information one of three ways -- to CMS on its Medicare Part B claims, to a qualified registry, or to CMS via a qualified electronic health record (EHR) system.

According to the CMS, qualified e-prescribing systems perform tasks such as transmitting prescriptions electronically, warning prescribers about potential allergic reactions and informing physicians about generic alternatives.

The eRx Incentive Program began Jan. 1, 2009. It is implemented annually by the CMS, with all updates and changes published in the Federal Register. The financial incentive is set to reduce to 1% for 2011 and 2012 and 0.5% for 2013. In addition, eligible health care professionals will start to face penalties, in the form of reduced Medicare payments, if they do not meet e-prescribing criteria. The reduction in Medicare payments is 1% for failing to begin e-prescribing by 2012, 1.5 for not doing so by 2013 and 2% for 2014 and all years after that.

Learn more:

Why e-prescribing alerts cannot be ignored.

Using mobile health technology to enable e-prescribing.

This was last updated in February 2010
Posted by: Margaret Rouse

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