Medicaid vs. Medicare EHR Incentive Programs

Generally, providers can only participate in either the Medicare or Medicaid EHR incentive program each year.

 

The following is an outline of which providers are eligible for the Medicare or Medicaid EHR incentive program:

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)
For more information on the differences between the Medicare and Medicaid EHR incentive programs, please visit: http://www.cms.gov/EHRIncentivePrograms/Downloads/ComparisonChart.pdf.

 

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