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Experience. Integrity. Advocacy.

Electronic Prescriptions for DME Included in CMS eRx Incentive Program

Reporting electronic prescriptions (eRx) to Medicare for 2012 dates of service can earn medical providers a one percent incentive payment as well as help them avoid a two percent payment adjustment in 2014. To make this measure even easier to attain, the Centers for Medicare and Medicaid Services (CMS) includes electronic prescriptions for durable medical equipment, along with pharmaceuticals, in the guidelines.

According to a FAQ on the CMS website, “any and all Durable Medical Equipment, Prosthetic and Orthotic Supplies (DMEPOS) that can be transmitted electronically can also be counted as ‘valid eRx events’ for the eRx Incentive Program.” This provision includes DME-prescribed walkers, shoes/socks for diabetic patients, diabetic testing supplies, insulin pumps, leg braces, etc.

Because DME supplies are paid for under the DME fee schedule, however, the charges for these supplies will not be included in the Medicare allowed charges from which the incentive and payment adjustment amounts are calculated.

To include these DME prescribing events in the required 25 eRx events of the measure, providers should bill the G8553 submission code with the eligible denominator visit code. In addition, providers would need to meet the normal eRx requirement of using a qualified eRx system to electronically issue the prescription.

Follow these links for more information on the CMS eRx Incentive Program or how to avoid future eRx payment adjustments.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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