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Medicare Payments

Incentive Payments

Medicare

Eligible professionals who successfully demonstrate meaningful use of certified EHR technology during the relevant EHR reporting period may be eligible for an incentive payment amount, subject to an annual limit, equal to 75 percent of the EP’s Medicare allowed charges submitted not later than two months after the end of the calendar year.  The table below  illustrates the maximum incentive payments an EP can receive by year and the total incentive payments possible if an EP suc­cessfully demonstrates meaningful use and qualifies for an incentive payment each year.


Maximum Incentive Payments for Medicare Eligible Professionals

Incentive Chart 1

Health Professional Shortage Area

The amount of the annual EHR incentive payment limit for each pay­ment year be increased by 10 percent for EPs who predominantly furnish more than 50 percent of services in an area that is designated by the Secretary (under section 332(a)(1)(A) of the PHS Act) as a geographic health professional shortage area (HPSA).

Payment Adjustments Beginning in 2015

If an EP does not successfully demonstrate meaningful use of certified EHR technology, the EP’s Medicare physician fee schedule amount for covered professional services will be adjusted by the applicable payment adjustment speci­fied in the Recovery Act beginning in 2015. The payment adjustments will be as follows:

  • 2015—99 percent of Medicare physician fee schedule covered amount
  • 2016—98 percent of Medicare physician fee schedule covered amount
  • 2017 and each subsequent year—97 percent of Medicare physician fee schedule covered amount
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