CMS Clarifies MU Payment Processes

The Centers for Medicare and Medicaid Services has revised a frequently asked question on its EHR Incentive Programs Web site to further clarify the payment process for achieving meaningful use.


The Centers for Medicare and Medicaid Services has revised a frequently asked question on its EHR Incentive Programs Web site to further clarify the payment process for achieving meaningful use.

The question: How do I get paid for the Electronic Health Records Incentive Programs?

The answer: For eligible professionals (EPs), incentive payments for the Medicare EHR Incentive Program will be made approximately four to eight weeks after an EP successfully attests that they have demonstrated meaningful use of certified EHR technology. However, EPs will not receive incentive payments within that timeframe if they have not yet met the threshold for allowed charges for covered professional services furnished by the EP during the year.

Payments will be held until the EP meets the $24,000 threshold in allowed charges for calendar year 2011 in order to maximize the amount of the EHR incentive payment they receive. If the EP has not met the $24,000 threshold in allowed charges by the end of calendar year 2011, CMS expects to issue an incentive payment for the EP in March 2012 (allowing 60 days after the end of the 2011 calendar year for all pending claims to be processed). Payments to Medicare EPs will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same channels their claims payments are made. The form of payment (electronic funds transfer or check) will be the same as claims payments.

Bonus payments for EPs who practice predominantly in a geographic Health Professional Shortage Area (HPSA) will be made as separate lump-sum payments no later than 120 days after the end of the calendar year for which the EP was eligible for the bonus payment.

Please note that the 90-day reporting period an EP selects does not affect the amount of the EHR incentive payments. The Medicare EHR incentive payments to EPs are based on 75% of the estimated allowed charges for covered professional services furnished by the EP during the entire payment year. If the EP has not met the $24,000 threshold in allowed charges at the time of attestation, CMS will hold the incentive payment until the EP meets the threshold as described above.

Medicare EHR incentive payments to eligible hospitals and critical access hospitals (CAHs) will also be made approximately four to eight weeks after the eligible hospital or CAH successfully attests to having demonstrated meaningful use of certified EHR technology. Eligible hospitals and CAHs will receive an initial payment and a final payment. Eligible hospitals and CAHs that attest in April can receive their initial payment as early as May 2011. Final payment will be determined at the time of settling the hospital cost report.

Please note that the Medicaid incentives will be paid by the States, but the timing will vary according to State. Please contact your State Medicaid Agency for more details about payment.