Medicare Quality Reporting Incentive programs Manual (Pub. 100-22), Ch. 2 § 60.2.2
Criteria for Determination of Successful Electronic Prescriber
60.2.2 – Criteria for Determination of Successful Electronic Prescriber
for the Payment Adjustments – Group Practices
(Rev. 10, Issued: 07-27-12, Effective: 10-29-12, Implementation: 10-29-12)
For the 2012 payment adjustment, a group practice is considered a “successful electronic
prescriber” if, depending on the group’s size, the group practice reports the eRx measure
via claims on 75-2,500 unique eRx events for patients in the denominator of the measure
for services occurring between January 1, 2011 and June 30, 2011. The following table
shows the required number of instances a group practice must report the eRx measure
according to group size:
20
Group size (Number of
Eligible Professionals)
Required Number of Unique Visits Where an Electronic
Prescription was Generated to be a Successful Electronic
Prescriber
2-10
75
11-25
225
26-50
475
51-100
925
101-199
1875
200+
2500
For the 2013 payment adjustment, a group practice is considered a “successful electronic
prescriber” if the group meets the criteria for the 2011 incentive. A group practice may
also be considered a “successful electronic prescriber” if, depending on the group’s size,
the group practice reports the eRx measure’s numerator via claims on 625 (for group
practices comprised of 25-99 eligible professionals) or 2,500 (for group practices
comprised of 100+ eligible professionals) unique eRx events, regardless of whether the
event is associated with the eRx measure’s denominator, between January 1, 2012 and
June 30, 2012.
For the 2014 payment adjustment, a group practice is considered a “successful electronic
prescriber” if the group meets the criteria for the 2012 incentive. A group practice may
also be considered a “successful electronic prescriber” if, depending on the group’s size,
the group practice reports the eRx measure’s numerator via claims on 625 (for group
practices comprised of 25-99 eligible professionals) or 2,500 (for group practices
comprised of 100+ eligible professionals) unique eRx events, regardless of whether the
event is indicated in the eRx measure’s denominator, between January 1, 2013 and June
30, 2013.