To obtain the incentive in 2009, you have to report on the e-prescribing quality
measure for 50% of applicable cases. The e-prescribing measure has two basic elements: (1) a reporting denominator consisting of a specified set of service codes that defines the circumstances when the measure is reportable; and (2) a reporting numerator consisting of a set of specific “G” -codes, one of which must be reported for successful reporting.
When you have an applicable case (defined by engaging in one of the service codes listed in Step 1 below for a Medicare Part B Fee-For-Service beneficiary), you report on the e-prescribing measure with two steps:
Step 1. Bill on one of the following service denominator codes:
90801 | 92004 | 99201 | 99215 |
90802 | 92012 | 99202 | 99241 |
90804 | 92014 | 99203 | 99242 |
90805 | 96150 | 99204 | 99243 |
90806 | 96151 | 99205 | 99244 |
90807 | 96152 | 99211 | 99245 |
90808 | 99212 | G0101 | |
90809 | 99213 | G0108 | |
92002 | 99214 | G0109 |
*Codes in bold typically billed by internists.
Step 2. Report one of the three G-codes listed below on more than 50% of applicable
cases for the numerator. All three codes (even the code for not generating prescriptions)
count toward the e-prescribing incentive. One of the G codes must be reported on the
same claim as the denominator billing code.
E-prescribing Incentive Program Quick Reference: G -Codes
If You… | Report |
Used a qualified e-prescribing system for all of the prescriptions | G8443 |
Had a qualified e-prescribing system, but didn’t generate any prescriptions during this encounter | G8445 |
Had a qualified e-prescribing system, but could not electronically submit one or more of the generated prescriptions because: • The prescription was for narcotics or other controlled substances. • State or Federal law required you to phone in or print the prescriptions. • The patient asked that you phone in or print the prescriptions. • The pharmacy system was unable to receive an electronic transmission. |
G8446 |
*** Work Flow Suggestion—Add the three e-prescribing measure numerator G-Codes to your superbill.