What are the details on receiving payment for Stage 1?

  • Details vary between Medicare and Medicaid, please see the CMS website for full detailed information
  • One lump sum check each year
  • Medicare Incentive Payment Calculation: 75% of allowable Medicare charges with a yearly maximum (see table below)
  • Medicare Payment Timeline: After meaningful use requirements have been met and reported, payments are sent four to six weeks after the maximum incentive is reached (exception for Medicaid Program year one of adption and implementation)
  • Medicaid Incentive Payments: Flat yearly payment maximum (not claims based) (see table below)
  • Medicaid Payment Timeline: States will pay no later than 5 months after you register; most sooner.

Medicare Maximum Incentive Payments

  CY 2011 CY 2012 CY 2013 CY 2014

CY 2015
and later**

CY 2011  $18,000        
CY 2012  $12,000  $18,000      
CY 2013  $8,000
 $12,000  $15,000    
CY 2014  $4,000  $8,000  $12,000  $12,000  
CY 2015  $2,000  $4,000  $8,000  $8,000  $0
CY 2016
   $2,000  $4,000  $4,000  $0
 TOTAL  $44,000 $44,000
 $39,000  $24,000  $0

 

**Note: In 2015, Medicare EP's not demonstrating meaningful use will have payment adjustments starting at 1% the first year and increasing each year to a maximum of 5%.

 

Medicaid Maximum Incentive Payments

  CY 2011 CY 2012
CY 2013 CY 2014 CY 2015 CY 2016
CY 2011 $21,250
         
CY 2012 $8,500 $21,250        
CY 2013 $8,500 $8,500 $21,250      
CY 2014 $8,500 $8,500 $8,500 $21,250    
CY 2015 $8,500 $8,500 $8,500 $8,500 $21,250  
CY 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250
CY 2017
$8,500 $8,500 $8,500 $8,500 $8,500
CY 2018     $8,500 $8,500 $8,500 $8,500
CY 2019       $8,500 $8,500 $8,500
CY 2020         $8,500 $8,500
CY 2021           $8,500
TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750

 

Notes:

  • Pediatricians with a Medicaid patient volume of 20%-30% have lower annual maximums.
  • Eligible Professionals have already received payment under the Medicaid program simply by adopting and implementing a certified EHR/EMR in 2011.

 

 


 

Note: All information provided is intended to be a helpful overview.  Please visit the CMS website for the written law and regulations.

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