To avoid a 1% pay cut in 2012, make sure you meet the e-prescribing deadline in the following 4 steps.
- Choose an e-prescribing solution - Free e-prescribing systems are typically web-based and stand alone. The good news is that you can start e-prescribing today! The bad news is that with a standalone solution, you will not have the ability to migrate e-prescribing data such as patient names and demographics into a EHR down the road.
- Don’t forget about the bonus - The June 30 deadline is all about the deadline to avoid the 1% pay cut in 2012 but don’t forget the bonus in 2011. Providers can earn a 1% payment bonus if they use e-prescribing 25 times before 2011 ends.
- Tip – To get the bonus e-prescriptions will need to be made for 25 unique patients by 12/31/2011.
- Tip – The penalty for not using e-prescribing in 2012 is 1%, 1.5% in 2013. E-Prescribing is also one of the Meaningful Use requirements if you’re hoping to use your HER to get the Meaningful Use incentive, potentially worth up to $44,000 per provider over the next 5 years. Don’t miss out!
- Use the right G-code – You must report G8553 on claims that include an e-prescription. Medicare contractors have edits in place to look for this modifier, both to penalize providers who don’t come up with the 10 e-prescriptions by June 30 and to award the 1% bonus in 2012 to those who get the 25 e-prescriptions by December 31, 2011.
- Make Sure you are not exempt – Providers get a free pass out of the e-prescribing if they can meet one of the three exemptions…
- G8644 - Lacking prescribing privileges
- G8642 - Practicing in a rural area without high-speed internet
- G8643 - Practicing in an area where most pharmacies lack the ability to receive e-prescriptions
- Note – Many non-physician practitioners (NPPs), such as nurse practitioners, and physician assistants, do have prescribing privileges and cannot use G8644 to get out of the e-prescribing requirement.
- Note – Providers who see less than 100 Medicare patients between January 1 and June 30, 2011 are also exempt from the rule.
We hope this information from TCI researchers help your billing department assure correct payment for claims.
Please contact us if you have any questions. |
