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Provider Incentive Amount

Participation Initiated by 2016

An eligible provider can receive a total of $63,750 over the course of six years. Payment years do not need to be consecutive (for example, if you do not meet the meaningful use criteria, you may skip payment years). Eligible Providers (EPs) must initiate participation no later than 2016.

In the first year of the program, EPs will receive $21,250 and $8,500 over the subsequent five years of participation up to payment year 2021. Incentive payments for pediatricians who meet the 20 percent Medicaid patient volume but fall short of the 30 percent Medicaid patient volume are reduced to two-thirds of the incentive payment. This means some pediatricians may receive $14,167 in the first year and $5,667 in subsequent years.

Provider Incentive Payment Payout Examples

Payment
Year
EP participates in
consecutive years
starting in 2011
EP participates in
non-consecutive
years
EP initiates
payments
in 2016
2011 $21,250 $0 $0
2012 $8,500 $21,250 $0
2013 $8,500 $0 $0
2014 $8,500 $8,500 $0
2015 $8,500 $8,500 $0
2016 $8,500 $8,500 $21,250
2017 $0 $0 $8,500
2018 $0 $0 $8,500
2019 $0 $8,500 $8,500
2020 $0 $8,500 $8,500
2021 $0 $0 $8,500
TOTAL $63,750 $63,750 $63,750

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