Medicaid vs Medicare
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 go here.
Hospitals may receive incentive payments in the same payment year from both Medicaid and Medicare if they meet all eligibility criteria.
For more information on the Medicare EHR Incentive Program, please visit the Center for Medicare and Medicaid Services website.