Three Steps to e-Prescribing

Online Resources Available for Physicians

Through Medicare's e-prescribing, eligible physicians can save time, enhance office and pharmacy productivity, and improve patient safety and quality of care while earning incentives from Medicare.

Interested? Here's what the Centers for Medicare & Medicaid Services (CMS) says physicians should do:

Step 1: Obtain an eligible system. Physicians must have or acquire a qualified electronic prescribing system that can generate a complete medication list with available data from pharmacies and benefit managers; select medications and transmit prescriptions electronically (not via fax) following applicable federal standards, after warning the prescriber of any possible safety issues associated with the drug orders; provide information on lower-cost, therapeutically appropriate alternatives; and provide drug plan information, such as formularies, patient eligibility and authorization requirements.

Step 2: Report the appropriate measures. Starting with applicable services rendered on or after January 1, 2009, physicians must report the appropriate combination of CPT codes and special G-codes on Medicare claims. For example, a doctor might bill code 99213 for a mid-level patient checkup and also report code G8443 if the visit resulted in an electronic drug order. Code G8445 applies for visits during which no prescriptions were ordered. G8446 applies when the drug orders could not be made electronically because of pharmacy limitations, federal or state restrictions, or patient preference.

Step 3: Qualify for a bonus. Physicians must submit all claims including e-prescribing codes no later than two months after the end of 2009. To be eligible for the bonus, the services a doctor provided that can be linked to an e-prescribing measure must make up at least 10 percent of his or her Medicare charges for the year. In addition, the physician must report the appropriate G-codes for at least 50 percent of the cases in which they apply. If CMS determines a physician qualified, he or she will receive a two percent bonus on all 2009 Medicare pay. Bonuses will be paid in 2010.

For additional information about e-prescribing, also visit www.cms.hhs.gov/PQRI (select E-prescribing Incentive Program); www.cms.hhs.gov/eprescribing (for information on Part D e-prescribing standards that will be effective April 1, 2009); and www.ehealthinitiative.org to download A Clinician's Guide to Electronic Prescribing.


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