EMR Incentive Center

FAQs Eligible Providers

Incentive Reimbursement Requirements for Medicaid and Medicare -What You Need To Know

Who is eligible for Medicare incentive reimbursements?

Office-based EPs who demonstrate meaningful use of an electronic medical record (EMR) system, including Doctor(s) of Medicine or Osteopathy, Doctor(s) of Dental Surgery or Dental Medicine, Doctor(s) of Podiatric Medicine, Doctor(s) of Optometry and Chiropractors, are eligible. Hospital-based EPs are not.

Who is eligible for Medicaid incentive reimbursements?

Those allowed to submit for incentives include physicians, nurse practitioners(NPs), certified nurse-midwives (CNMs), dentists and physician assistants(PAs) working in a Federally Qualified Health Center (FQHC) or rural health clinic (RHC) that is so led by a PA.

Who is not eligible for incentive reimbursements?

Providers furnishing more than 90% of their services in an inpatient setting or hospital ER.

Provider Requirements

Of course, only Medicare and Medicaid providers are eligible for a CMS EHR Incentive Program. Providers must be meaningfully using an EMR certified by an ONC Approved Testing and Certification Body (ATCB) for 90 days consecutively in the first reimbursement payment year. For future reimbursement years, providers must meaningfully use the system for the full year. Providers will need to select and register for a single program from which to receive incentives, either Medicare or Medicaid. Providers will also need to “attest” that they are meaningfully using a certified EMR according to the selected program requirements through self-attestation, claims data and EMR-generated reports. The reimbursement is not limited to first time EMR users. Providers already using a certified EMR are also eligible.

What’s next? Register for a program

Providers may register for the Medicare program now through the CMS EHR Incentive Program Website. As the Medicaid incentive programs established by each state, providers will need to check with their state Medicaid organization to verify if and when their state program will be open for registration, as well as what the state will require that may be different from the federal Medicaid program. Click here to access the CMS list of Medicaid programs and their current status.

Have questions, e-mail stimulus@micromd.com