E-Prescribing Bonus Details

April 1, 2009

We were wondering if it’s worth participating in CMS’ e-prescribing bonus program. Is the 2 percent that Medicare will reimburse actually 2 percent of all submitted charges? It seems there’s some “hidden” work that goes along with this program. Can you give me more detail?

 

Question: We were wondering if it’s worth participating in CMS’ e-prescribing bonus program. Is the 2 percent that Medicare will reimburse actually 2 percent of all submitted charges? It seems there’s some “hidden” work that goes along with this program. Can you give me more detail?

Answer: Well, first you have to use software that can:

  • Transmit prescriptions directly to the pharmacy’s computer;

 

 

  • Generate a medication list; and

 

 

  • Automatically alert prescribers to adverse drug interactions and allergies.

There is a list of vendors at www.surescripts.com.

 

The only other hurdle is that you have to report your e-prescribing activities with one of two G-codes. One indicates that you e-prescribed during that visit. The other one shows you didn’t happen to write a script but did have e-prescribing in place should you have decided to. For details on the codes, visit the CMS e-prescribing Web site at www.cms.hhs.gov/eprescribing.

Reporting either G code for 50 percent of eligible patients qualifies you for the bonus. The 50 percent threshold applies only to encounters involving several dozen CPT codes, most of them for E&M services. E-prescribing in conjunction with other CPT codes won’t count.

Remember this, too: The bonuses will phase out by 2011 to be replaced with penalties, so you might as well get on board. You also can save a lot of workload time and expense using e-prescribing, so these cost savings may outweigh the cost of getting a program.