Meaningful use and e-prescribing incentives

June 10, 2011

Understand whether meaningful use and e-prescribing incentives are based only on Medicare Part B patients.

Q: Are the meaningful use and the e-prescribing incentives for physicians based only on Medicare Part B patients? What about patients with Medicare supplemental plans?

A: In general, both meaningful use and e-prescribing only count Medicare Part B claims. This means that services charged under Medigap/Medicare supplemental insurance or other private insurances will not qualify.

Both meaningful use and the e-prescribing program only apply to "covered professional services," which are defined as services "for which payment is made under, or is based on, the Medicare physician fee schedule."

CMS has explicitly stated that the denominator is reportable when specific billing codes for covered services are billed for Part B covered professional services. Based on this language, only Medicare Part B services will qualify for meaningful use and e-prescribing purposes.

Answer provided by Daniel F. Shay, JD, of Alice G. Gosfield and Associates PC, Philadelphia, Pennsylvania. Send your practice management questions to medec@advanstar.com
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