How to Report the E-prescribing Incentive Program Measure

To obtain the incentive in 2009, you have to report on the e-prescribing quality
measure for 50% of applicable cases. The e-prescribing measure has two basic elements: (1) a reporting denominator consisting of a specified set of service codes that defines the circumstances when the measure is reportable; and (2) a reporting numerator consisting of a set of specific “G” -codes, one of which must be reported for successful reporting.
When you have an applicable case (defined by engaging in one of the service codes listed in Step 1 below for a Medicare Part B Fee-For-Service beneficiary), you report on the e-prescribing measure with two steps:

Step 1. Bill on one of the following service denominator codes:

90801 92004 99201 99215
90802 92012 99202 99241
90804 92014 99203 99242
90805 96150 99204 99243
90806 96151 99205 99244
90807 96152 99211 99245
99212 G0101
99213 G0108
99214 G0109

*Codes in bold typically billed by internists.

Step 2. Report one of the three G-codes listed below on more than 50% of applicable
cases for the numerator. All three codes (even the code for not generating prescriptions)
count toward the e-prescribing incentive. One of the G codes must be reported on the
same claim as the denominator billing code.
E-prescribing Incentive Program Quick Reference: G -Codes

If You...          Report
Used a qualified e-prescribing system for all of the prescriptions G8443
Had a qualified e-prescribing system, but didn’t generate any prescriptions during this encounter G8445
Had a qualified e-prescribing system, but could not electronically submit one or more of the generated prescriptions because:                                                                                   • The prescription was for narcotics or other controlled substances.
• State or Federal law required you to phone in or print the prescriptions.
• The patient asked that you phone in or print the prescriptions.
• The pharmacy system was unable to receive an electronic transmission.                                            

*** Work Flow Suggestion—Add the three e-prescribing measure numerator G-Codes to your superbill.

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