Differences Between
the Medicare and Medicaid EHR Incentive Programs
With the exception of
dually-eligible hospitals, providers can only participate in one of the EHR
Incentive Programs—Medicare or Medicaid—each year. This message
outlines key differences between the Medicare and Medicaid EHR Incentive
Programs to help you determine which EHR Incentive Program is right for you.
Who is eligible?
For the Medicare EHR
Incentive Program, eligible participants include:
·
Doctors of medicine
or osteopathy
·
Doctors of dental
surgery or dental medicine
·
Doctors of podiatry
·
Doctors of optometry
·
Chiropractors
·
"Subsection (d)
hospitals" in the 50 states or DC that are paid under the Inpatient
Prospective Payment System (IPPS)
·
Critical Access
Hospitals (CAHs)
·
Medicare Advantage
(MA-Affiliated) Hospitals
For the Medicaid EHR
Incentive Program, eligible participants include:
·
Physicians
(primarily doctors of medicine and doctors of osteopathy)
·
Nurse practitioners
·
Certified
nurse-midwives
·
Dentists
·
Physician assistants
who furnish services in a Federally Qualified Health Center or Rural Health
Clinic that is led by a physician assistant
·
Acute care hospitals
(including CAHs and cancer hospitals) with at least 10% Medicaid patient
volume
·
Children's hospitals
(no Medicaid patient volume requirements)
Dually-Eligible
Hospitals
If you represent a hospital that meets all of the following qualifications, you
are dually-eligible for the Medicare and Medicaid EHR Incentive Programs:
·
You are a
subsection(d) hospital in the 50 U.S. States or the District of Columbia, or
you are a CAH; and
·
You have a CMS
Certification Number ending in 0001-0879 or 1300-1399; and
·
You have 10% of your
patient volume derived from Medicaid encounters.
We encourage potential
participants to review CMS' comparison chart to
learn more about the differences between the two EHR Incentive Programs, and
use the Eligibility Wizard to
determine for which program they may be eligible.
Want more information about
the EHR Incentive Programs?
Make sure to visit the EHR Incentive Programs website
at for the latest news and updates on the EHR Incentive Programs.
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