Wednesday, June 1, 2011

AM I Eligible to get Medicare e-Prescribing Incentive for 2011? List of denominator codes

Are you an eligible professional attempting to earn the CMS e-Prescribing Incentive for 2011?

*  Send 25 or more e-prescriptions for 25 Medicare Part B patient visits which include one of the e-prescribing denominator codes*

AND

* Send your 25 claims to Medicare Part B with the denominator code* and code G8553 by

12/31/2011

G8553: At least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx system


* Measure Denominator Codes:
Patient visit during the reporting period (CPT or HCPCS):
90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download