EHR Incentives & Certification

EHR Incentive Programs

Medicare and Medicaid EHR Incentive Programs

The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals and hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified electronic health records (EHR_ technology.

  • Demonstrating meaningful use of certified EHRs takes time and resources. Eligible professionals (EPs) and hospitals can receive financial support from the CMS Medicare and Medicaid EHR Incentive Programs. EPs can qualify for incentive payments totaling as much as $44,000 through the Medicare Incentive Program, or as much as $63,750 through the Medicaid Incentive Program.
  • Eligible hospitals, including critical access hospitals, can qualify for incentive payments totaling some $2 million or more.

Medicare EPs

  • Doctors of medicine or osteopathy
  • Doctors of dental surgery or dental medicine
  • Doctors of podiatric medicine
  • Doctors of optometry
  • Chiropractors

Medicare Eligible Hospitals

  • "Subsection (d) hospitals" that are paid under the hospital inpatient perspective payment system
  • Critical Access Hospitals (CAHs)
  • Medicare Advantage (MA) Hospitals

Medicaid EPs

  • Physicians
  • Nurse practitioners
  • Certified nurse-midwives
  • Dentists
  • Physician Assistants (PAs) in PA-led Federally Qualified Health Centers (FQHC) or rural health clinics (RHC)

Medicaid Eligible Hospitals

  • Acute care hospitals (including CAHs) with at least 10% Medicaid patient volume
  • Children's hospitals (no Medicaid volume required)

Dually-Eligible Hospitals

A hospital is dually-eligible for the Medicare and Medicaid EHR Incentive Programs if it meets the following criteria:

  • You are a subsection (d) hospital in the 50 U.S. States or the District of Columbia, or you are a Critical Access Hospital (CAH); and
  • You have a CMS Certification Number ending in 0001-0879 or 1300-1399; and
  • You have 10% of your patient volume derived from Medicaid encounters.

Medicare EHR Incentive Payments

  • Maximum incentives are $44,000 over five consecutive years
  • Incentive payments decrease if starting after 2012
  • Must begin by 2014 to receive incentive payments; last payment year is 2016
  • Extra amount available for eligible professionals practicing in predominantly Health Professionals Shortage Areas
  • Eligible hospitals (including CAHs) can qualify for incentive payments totaling some $2 million or more.

Medicaid EHR Incentive Payments

  • Maximum incentives are $63,750 over six years (do not need to be consecutive)
  • The first year payment is $21,250; $8,500 for next five years
  • Must begin by 2016 to receive incentive payments; last payment year is 2021
  • To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:
    • Have a minimum 30% Medicaid patient volume
    • Have a minimum 20% Medicaid patient volume, and is a pediatrician
    • Practice predominantly in a FQHC or RHC and have a minimum 30% patient volume attributable to needy individuals.

Medicare EHR Incentive Program Checklist

How to receive a Medicare payment:

  • Verify your eligibility for the Medicare EHR Incentive Program.
  • Get registered.
    • Registration is now open to eligible professionals and eligible hospitals. You can register before having a certified EHR system installed.
  • Use certified EHR technology.
  • Demonstrate meaningful use.
    • Successfully demonstrate meaningful use for a consecutive 90-day period in your first year of participation (and for a full year in each subsequent year) to receive EHR incentive payments. EPs must meet specific objectives and report on specific clinical quality measures.
  • Attest to demonstrating meaningful use.
    • To get your EHR incentive payment, you must attest (legally state) through Medicare's secure website that you've demonstrated meaningful use with certified EHR technology.

Medicaid EHR Incentive Program Checklist

How to receive a Medicaid payment:

For more details, visit the CMS official website for the Medicare and Medicaid EHR Incentive Programs.

Get Help

Need support on EHR adoption and meaningful use? Contact your local Regional Extension Center (REC). Your local REC offers direct, on-the-ground EHR implementation expertise and support.