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Medicare E-Prescribing Incentive Program

As of Jan 1, 2014 Providers do not send the G8553 HCPC code. The code has been discontinued. All affected providers should be using a qualified EHR that is capable of electronic prescribing. See this CMS page for more information  CMS Information on Electronic Prescribing

This page is intended to be a collection point on how to participate in the Medicare E-Prescribing Incentive Program. It is not intended to be a replacement to any CMS guideline. InterfaceEDI/MegaEasy Computer Solutions does not guarantee or warranty the information collected here.
 
CMS web page
 
to participate in this incentive program a provider must follow the rules spelled out by CMS.
 
the following is beleived to be what is necessary in Medisoft to get credit for using a qualified E-Prescribing system in your office.
 
for claims containing one or more of the following codes in which the issued an E-Prescription.

90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, G0101, G0108, G0109

 

an extra procedure code must be added to the claim, chose from one of the following.

G8443 - "All prescriptions created during the encounter were generated using a qualified e-prescribing system."

G8445 - "No prescriptions were generated during the encounter."

G8446 - "Provider does have access to a qualified e-prescribing system and some or all of the prescriptions generated during the encounter were printed or phoned in as required by the State or Federal Law or regulations, patient request or pharmacy system being unable to receive electronic transmission; or because they were for narcotics or other controlled substances."

the charge amount should be zero. make sure the diagnosis code pointers apply at least one diagnosis code.