eRX Incentive Program Educational Resources

The eRx Incentive Program Ended in 2013, but Electronic Prescribing Continues with Meaningful Use

2013 was the final program year for participating and reporting in the Medicare Electronic Prescribing (eRx) Incentive Program. The 6-month 2014 eRx payment adjustment reporting period, which began on January 1, 2013 and ended on June 30, 2013, was the final reporting period to avoid the 2014 eRx payment adjustment. You do not need to report G-codes (G8553) for 2014 eRx events.

• 2013 was the last year to earn an eRx incentive payment
• 2014 is the last year to incur an eRx payment adjustment

Content will remain available on this website so participants have an opportunity to access reference materials associated with the eRx incentive payment, payment adjustment, and feedback reports.

Note: electronic prescribing via certified EHR technology is still a requirement for eligible professionals in order to achieve meaningful use under the Medicare and Medicaid EHR Incentive Programs. Visit the EHR website for more information.

The educational resources listed on this web page are designed to increase national awareness of the Electronic Prescribing (eRx) Incentive Program. Eligible professionals are encouraged to contact their professional organizations for additional information and tools that will facilitate participation in the eRx Incentive Program.

2013 Quality Reporting Programs Matrix

This matrix provides practical summaries of three quality reporting programs—the Value Modifier, Physician Quality Reporting System (PQRS), and the eRx Incentive Program—that affect payments to physicians and other EPs.  

Tips for Using the Quality Reporting Communication Support Page

A document titled "Tips for Using the Quality Reporting Communication Support Page" has been posted below in the "Downloads" section.  This document provides tips for entering an eRx Hardship Exemption Request to avoid the 2014 eRx Payment Adjustment, a PQRS/eRx Feedback Report Request, a PQRS Informal Review Request and a Self-Nomination Request.  Please note self-nomination only applies to certain entities, including Maintenance of Certification Boards, Registries, EHR vendors and group practices wishing to participating in the Group Practice Reporting Option (GPRO).

CMS educational resources include:

• eRx Incentive Program Educational Products
• MLN Matters Articles

eRx Incentive Program Educational Products

The following educational products are available to assist eligible professionals with 2013 eRx Incentive Program reporting and are available in the "Downloads" section below:

• 2013 eRx Incentive Program: 2014 Payment Adjustment. 

 This article provides guidance on avoiding the 2014 eRx payment adjustment.  To view click on the document titled "2013 eRx Incentive Program: 2014 Payment Adjustment".

• 2013 eRx Payment Adjustment Informal Review Made Simple

This Fact Sheet provides step-by-step guidance for those eligible professionals and eRx GPROs receiving the 2013 eRx payment adjustment who wish to request an informal review of the 2013 eRx payment adjustment determination.

• 2013 eRx CMS-1500 Claim Example

A detailed sample of an Individual NPI reporting the eRx measure on a CMS-1500 claims is shown in the document titled "2013 eRx CMS-1500 Claim Example" in the "Downloads" section below.

• 2013 eRx Incentive Incentive Program GPRO: Participation for the Incentive Payment Made Simple 

A "2013 eRx Incentive Program GPRO: Participation for the Incentive Payment Made Simple" document for group practices wishing to participate in the 2013 eRx Incentive program for incentive purposes through GPRO has been posted in "Downloads" section below.

• 2013 eRx Incentive Program: Participation for the Incentive Payment Made Simple

This Fact Sheet provides step-by-step advice for participating in the 2013 eRx Incentive Program. This document applies to the eRx Incentive Program for incentive payment eligibility only and does not provide guidance for avoiding future payment adjustment(s).

• eRx Incentive Program: Updates for 2013

This Fact Sheet contains information about changes to the 2013 eRx Incentive Program incentive payment and the 2014 eRx payment adjustment as authorized by MIPPA.

The following educational products are available to assist eligible professionals with 2012 eRx Incentive Program reporting and are available in the "Downloads" section below:

• 2012 PQRS and eRx Incentive Program GPRO: Participation for the Incentive Payment Made Simple. This Fact Sheet provides guidance for group practices wishing to participate in the 2012 PQRS  and the 2012 eRx Incentive program as a CMS selected group practice.

• 2012 eRx Incentive Program: Participation for the Incentive Payment Made Simple - This Fact Sheet provides step-by-step advice for participating in the 2012 eRx Incentive Program.

• 2012 eRx Incentive Program Updates for 2012 - This Fact Sheet contains information about changes to the eRx Incentive Program for 2012 and future payment adjustments as authorized by MIPPA.

The following educational products are available to assist EPs with 2011 eRx Incentive Program reporting and are available in the "Downloads" section below:

• Changes to 2011 Medicare eRx Incentive Program Final Rule Quick Reference Guide - This Quick Reference Guide provides an overview of information on the 2011 Final Rule Medicare changes to the eRx Incentive program.   

• 2011 eRx Incentive Program Made Simple Fact Sheet - This Fact Sheet provides step-by-step advice for participating in the 2011 eRx Incentive Program

• 2011 eRx Incentive Program Made Simple Quick Reference Chart - This Fact Sheet provides a reference chart to assist with participating in the 2011 eRx Incentive Program.

• PQRS Portal User Guide. A Physician Quality Reporting System Portal User Guide, designed to help EPs and their authorized users to access PQRS feedback reports, is now available.

• PQRS/eRx Submission Engine Validation Tool User Guide. This guide is an assistance for the use of the Submission Engine Validation Tool which provides a way for users to validate the format and content of data files when uploading them into the Submission Portlet. This document was released September 9, 2010.

eRx Incentive Program MLN Matters Articles

• MLN Matters Article SE1141 - 2012 eRx Payment Adjustment: Assessment and Application. This MLN Matters Special Edition Article describes how the 2012 eRx payment adjustment was 1) calculated and 2) applied for individual eligible professionals, and group practices participating in eRx GPRO). The article is available under the "Related Links Inside CMS" section below.

• MLN Matters Article SE1107 - 2011 eRx Incentive Program Update – Future Payment Adjustments. This MLN Matters Article provides an overview of future payment adjustments. Beginning in 2011, eligible professionals who are not successful electronic prescribers may be subject to a payment adjustment on their future Medicare Part B Physician Fee Schedule (PFS) covered professional services. The article is available under the "Related Links Inside CMS" section below.

• MLN Matters Article SE1120 -  Electronic Prescribing (eRx) Incentive Program 2011 Update. This Special Edition MLN Matters Article provides updated information about changes to the eRx Incentive Program for 2011. This article is available under the "Related Links Inside CMS" section below.  

• MLN Matters Article 6514 - Coding and Reporting Principles for the Physician Quality Reporting Initiative (PQRI) and the Electronic Prescribing (E-Prescribing) Incentive Programs. This MLN Matters Article was revised on November_2_2010. The updated version is available under the "Related Links Inside CMS" section below.

• MLN Matters Article 6394 - Program Overview: 2009 PQRI And The 2009 E-Prescribing Incentive Program. This MLN Matters Article was revised on November_2_2010. The updated version is available under the "Related Links Inside CMS" section below.

Communication Support Page User Manual

The Communication Support Page is available through QualityNet (www.qualitynet.org). A User Manual has been developed to provide step by step instructions on how to navigate through the Communication Support Page. To view this guide click on the link titled “Communication Support Page User Manual” in the “Related Links Outside CMS" section below.

Continuing Education

In October 2008, CMS and 34 partner organizations hosted a meeting about the mechanics of implementing an eRx program in a practice. Audiotapes and slides are now archived online for continuing education credit. Click on the Massachusetts Medical Society link under the "Related Links Outside CMS" section below to view the presentations and hear the audiotapes of the program. There are no registration or certificate fees.

Welcome to the eRx Incentive Program

This presentation provides an overview of the Medicare eRx Incentive Program.  Highlights include a brief program background, a look at the program website and documentation, high-level steps on how to get started; available resources and who to contact for help.

Other Links

• All eRx FAQs is an online tools where you can find answers to Frequently Asked Question.

• Quality Net Portal.  To access the Quality Net Portal click on the link below in the "Related Links" section.  

• Massachusetts Medical Society. This is an online continuing education portal of archived presentations from the National E-prescribing Conference held in Boston, Massachusetts on October 7, 2008. Presentations are in a multi-media format that may include synchronized audio to PowerPoint slides, and printable transcription. Physicians and pharmacists must complete the educational activities to receive CME or CE credit on selected presentations listed below. Additional instructions for claiming CME and CE credit are displayed with each course. All course materials and exams are offered free of charge.