Medicare and Medicaid EHR Incentive Program Basics

The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program.

Eligible hospitals and critical access hospitals (CAHs) should visit our Eligible Hospital Information page to learn about the EHR Incentive Programs.

Click on links below to learn more about the Medicare and Medicaid EHR Incentive Programs, including the years of participation and incentive payment amounts:

• Medicare Eligible Professionals.
  • Medicare EHR Incentive Payment Schedule for Eligible Professionals.
• Medicaid Eligible Professionals.
  • Medicaid EHR Incentive Payment Schedule for Eligible Professionals.
• Medicare Eligible Hospitals.
• Medicaid Eligible Hospitals.

Be sure to see the Education Resources and Frequently Asked Questions for more helpful information.

Medicare Eligible Professionals
The Medicare EHR Incentive Program for eligible professionals started in 2011, and EHR incentive payments under Medicare will continue through 2016. Depending on the first year they participate, eligible professionals can participate for up to 5 continuous years throughout the duration of the program. The last year to begin participation in the Medicare EHR Incentive Program is 2014.

• To receive the maximum EHR incentive payment, Medicare eligible professionals must begin participation by 2012.
• Eligible professionals who demonstrate meaningful use of certified EHR technology can receive up to $44,000 over 5 continuous years under the Medicare EHR Incentive Program. See the payment table below for more information.
• To qualify for Medicare EHR incentive payments, Medicare eligible professionals must successfully demonstrate meaningful use for each year of participation in the program.
• Incentive payments for eligible professionals are made based on the calendar year. The reporting period for the first year is any 90 continuous days during the calendar year. The reporting period for all subsequent years is the entire calendar year.
• Beginning in 2015, Medicare eligible professionals who do not successfully demonstrate meaningful use will be subject to a payment adjustment. The payment reduction starts at 1% and increases each year that a Medicare eligible professional does not demonstrate meaningful use, to a maximum of 5%.

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Medicare EHR Incentive Payment Schedule for Eligible Professionals

Additional incentives are available! Medicare eligible professionals who predominantly furnish services in an area designated as a Health Professional Shortage Area (HPSA) will receive a 10% increase in their annual EHR incentive payments.  (NOTE: The additional 10% HPSA incentive is not available for eligible professionals who participate in the Medicaid EHR Incentive Program.)

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Medicaid Eligible Professionals

The Medicaid EHR Incentive Program is offered and administered voluntarily by states and territories. There are currently 45 states that offer the EHR Incentive Programs, and we expect the remainder to open their programs in 2012. (Check our Medicaid State Information page to learn which states are offering EHR incentives.)

The Medicaid EHR Incentive Program will continue to pay incentives through 2021. Eligible professionals can participate for 6 years, and participation years do not have to be consecutive.. The last year that an eligible professional can begin participation in the Medicaid EHR Incentive Program is 2016.

• Incentive payments for eligible professionals are higher under the Medicaid EHR Incentive Payments— up to $63,750 over 6 years under the Medicaid EHR incentive program. See the payment table below for more information.
• Medicaid eligible professionals can receive an incentive payment for adopting, implementing, or upgrading,certified EHR technology in their first year of participation. In subsequent participation years, Medicaid eligible professionals can receive incentive payments for successfully demonstrating meaningful use.
• If you qualify for both the Medicare and Medicaid EHR Incentive Programs, you must choose which program you want to participate in. Find more information about the differences between the programs on our Getting Started page. Medicaid eligible professionals will not be subject to payment adjustments. However, Medicaid eligible professionals who also treat Medicare patients will have a payment adjustment to Medicare reimbursements starting in 2015 if they do not successfully demonstrate meaningful use.

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Medicaid EHR Incentive Payment Schedule for Eligible Professionals

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