ePrescribing Survivial Guide: Getting Your Ten Electronic Prescriptions Done in the Next 30 Days

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This is a busy time for most practices. Managers are preparing for the annual juggling act of getting staff and physicians coordinated for summer vacations. Practices are ramping up for new doctors joining their practice at the traditional end of residency programs in the summer. Many practices are in the midst of shopping for, negotiating for or implementing EMRs. And most everyone without an existing EMR is struggling with the e-prescribing deadline looming in 30 days. Read my first post on this topic here.

As a reminder:

  • Eligible professionals who are not successful e-prescribers, based on claims submitted between January 1, 2011 and June 30, 2011, may be subject to a “payment adjustment” (read payment cut) in their Medicare Part B Physician Fee Schedule (PFS) for covered professional services in 2012.
  • Those that do not e-prescribe as a part of 10 Medicare patient encounters by June 30, 2011 will only receive 99% of their Medicare payment for all encounters in 2012.
  • Those that do not e-prescribe as a part of 25 encounters by December 31, 2011, will only receive 98.5% of their Medicare payments for all encounters in 2013 and only 98% of their Medicare payments for encounters during 2014 and going forward.

Here are the problems practices have encountered trying to get their ten:

  • Physicians seeing patients in facilities and using the codes that are eligible for eRx, but not having the ability to e-prescribe during the visit
  • Physicians in specialties not prescribing many medications
  • Physicians in specialties prescribing predominantly controlled drugs, which are not currently eligible for electronic prescribing

Today, the AMA released this announcement

May 31, 2011

On May 26 the Center for Medicare and Medicaid Services (CMS) responded to AMA concerns about the e-prescribing penalty program and issued a proposed rule that makes significant changes to it by adding more exemption categories. These changes will assure that physicians are not unfairly penalized for failing to meet the requirements under the 2012 e-prescribing penalty program.

Physicians are still required to e-prescribe using a qualifying e-prescribing system and report the G8553 code on at least 10 Medicare Part B claims from Jan. 1, 2011, through June 30, 2011, to avoid the 2012 e-prescribing penalty.

However, to avoid the 2012 e-prescribing penalty, physicians now will have an opportunity to attest through an on-line web portal that they are eligible for one of the following penalty exemptions:

  • Physician’s practice is located in a rural area without high speed internet access
  • Physician’s practice is located in an area without sufficient available pharmacies for electronic prescribing
  • Physician is registered to participate in the Medicare or Medicaid EHR Incentive Program and has adopted certified EHR technology (New)
  • Physician is unable to electronically prescribe due to local, State, or Federal law or Regulation (e.g., prescribes controlled substances) (New)
  • Physician infrequently prescribes (e.g., prescribe fewer than 10 prescriptions between January 1, 2011 –June 30, 2011) (New)
  • There are insufficient opportunities to report the e-prescribing measure due to program limitations (e.g., surgeons) (New)

Physicians will have to apply for an exemption from the 2012 e-prescribing penalty via the web-portal tool by Oct. 1.

What if you don’t fall into one of these new categories?

It’s time to tap into one of the free electronic prescribing packages available. Here are two choices:

  1. The National ePrescribing Patient Safety Initiative (NEPSI) – Free, Allscripts Software
  2. Practice Fusion – Free, probably will have advertising and your data will be mined (all 10 prescriptions!) but you may be able to get it up and running very quickly


Some other thoughts on getting your ten done

  1. Prescribe over-the-counter drugs including stool softeners and anti-emetics.
  2. Prescribe Tylenol3 or another non-controlled pain reliever – patients do not need to pick these prescriptions up or pay for them.
  3. Ask your Medicare patients if they have any prescriptions they would like you to refill while they are in the office. Over-the-phone refills do not count as there is no associated face-to-face service.
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Posted in: Medicare & Reimbursement

Leave a Comment (14) ↓


  1. Virginia McGeorge June 11, 2011

    This was a very helpful post, Mary! Another issue that is currently being discussed in my area (greater Philadelphia)is that many prescriptions prescribed by surgeons are done during the postoperative period. The E&M code 99024 is not in the denominator list.

    • Mary Pat Whaley June 12, 2011

      Hi Virginia,

      Thanks for your comment. The original e-prescribing requirement had some very obvious flaws for any provider whose majority demographic is not patients who come to the office for non-surgical care.

      Best wishes,

      Mary Pat

  2. Lisa Goforth June 13, 2011

    Can someone please answer my question with a “yes” or “no” without referring me to websites: Does EVERY doctor that accepts Medicare have to eprescribe before June 30, 2011 to avoid penalties?

    • Mary Pat Whaley June 13, 2011

      Hi Lisa,

      The answer is “no”.

      Best wishes,

      Mary Pat

  3. Carol June 15, 2011

    Hi Mary Pat

    How do I get to the web portal to request exemption for one of my physicians?

    • Mary Pat Whaley June 15, 2011

      Hi Carol,

      They haven’t produced it yet, but I’ll be announced it here on MMP just as soon as it’s available.

      Best wishes,

      Mary Pat

  4. Robin June 22, 2011

    Hi, we have a group practice and are in the midst of installing an eRx system. We have not been using the G code however one of our providers has been using another eRx system for over a year (Allscripts). My question is, in order to meet the 10 rx requirement 1)does it only have to be one provider from the group who meets it and 2) is there any way to prove we have someone who has already been ePrescribing even though we didn’t use the G code? Needless to say we are scrambling right now.

    • Mary Pat Whaley June 22, 2011

      Hi Robin,

      1) Each provider must meet the requirement individually to be exempt from future Medicare reductions.
      2) You must use the G code to meet the requirement. This is from CMS: “For 2012 eRx Payment Adjustment analysis, the 10 required G8553 events MUST be reported via the claims reporting option, NOT via a CMS-qualified registry or qualified EHR. The six-month claims reporting period ends after June 30, 2011. As CMS is allowing just one month to receive submitted claims into the NCH file, the deadline is July 31, 2011.
      Please be aware that Medicare Part B Carriers/Medicare Administrative Contractors (MACs) only submit claims to the NCH every Friday, so the last Friday would be July 29, 2011. Participating eligible professionals are encouraged to ensure their claims have been submitted to Carriers/MACs by mid-July 2011 or earlier.”

      You can do it!

      Best wishes,
      Mary Pat

  5. Candace July 4, 2011

    After the 6/30/11 deadline, are we required to continue to submit the G code on claims and for how long will we need to do this? What exactly do they do with the information that we submit? Also what is the site to got to to register your EHR system with Medicare

    • Mary Pat Whaley July 5, 2011

      Hi Candace,

      If the regulation continues as currently stated, eligible providers will need to use the code 15 more times for a total of 25 during calendar year 2011. Using the code 10 times prior to June 30, 2011 protects you from a 1% reduction in Medicare payments in 2012. Using the code 15 additional times between July 1, 2011 and December 31, 2011 protects you from a 1.5% reduction in Medicare payments in 2013, and a 2% reduction in 2014 and years going forward. If you are already applying for the EHR meaningful use money (different program), you are not eligible for the e-prescribing money.

      Here is the link to register your EHR: https://ehrincentives.cms.gov/hitech/login.action

      Best wishes,

      Mary Pat

  6. Cynthia July 29, 2011

    Mary Pat ~

    I stumbled on your website and am so excited that I did. We are not currently using an EHR but have been using Allscripts for our eprescribing. We have met the 10 required eprescriptions and used the “G” code appropriately. All our claims have been filed and we did receive the N365 confirmation back on our remittance. My question is this, do we have to “attest” that we met our 10 or does the “G” code do this for us? Another question is that I have registered my doctors for the EHR Incentive Program even though we have not purchased an EHR. There is so much information out there and gets a little difficult to understand at times; I read your reply to Candace and am now questioning myself. We don’t want the cut in Medicare for the eprescribing and this is what matters to us right now. I am certain you can explain this to me. Thank you for your time.

    • Mary Pat Whaley July 31, 2011

      Hi Cynthia,

      You do not have to attest for the eprescribing, your G codes take care of that, however you do need to do 15 more per provider before the end of the calendar year. There is, however, a final rule proposed that may change the some of the current rules. You’re so right – how can anyone keep track of all of it? I’ll publish something if the rule does change.

      You are correct to have registered your docs for the EHR!

      Best wishes,

      Mary Pat