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Medicaid vs Medicare

Incentive Program Differences

For eligible providers, there is a difference between the Medicare EHR Incentive and the Medicaid EHR Incentive programs.
 
The Medicare EHR Incentive Program, administered by CMS, will provide incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.
 
The Medicaid EHR Incentive Program, administered at the state level, will provide incentive payments to eligible professionals, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.
 
Below is a quick comparison between the two programs to assist eligible providers.

Medicaid vs. Medicare Comparison Chart


Medicaid Medicare
Total Incentive Up to $63,750 Up to $44,000
Total Years
6 5
First Year's Payment $21,500 $18,000 (for 2011 or 2012)
Subsequent  Years
$8,500/year Steps down from $12,000 to $2,000
Patient Volume Reqs
Significant Medicaid Patient Volume Proportional to Part B
Allowable Claims
Adopt / Implement / Upgrade
Year 1 Only
No
Meaningful Use
Years 2-6 All Years
Continuous Participation
No Yes
Eligible Provider Types
Physician, Nurse Practitioner, Dentist, Physician Assistant* (under special circumstances) Doctor of medicine or osteopathy, Doctor of oral surgery or dental medicine, Doctor of podiatric medicine, Doctor of Optometry, Chiropractor
As a provider for the Medicare and Medicaid EHR Incentive Program, see the basics.



Hospitals may receive incentive payments in the same payment year from both Medicaid and Medicare if they meet all eligibility criteria.

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