Public Service Message

Better Information Means Better Care: Health Information Technology

Meaningful Guidance

Definitions

  1. Certified EHR Technology:
    1. A Complete EHR that meets the requirements of a Qualified EHR and has been tested and with the certification program established by ONC as having met all applicable certification criteria adopted by the secretary; Or
    2. A combination of EHR Modules in which each constituent EHR Module of the combination has been tested and certified in accordance with the certification program established by ONC as having met all applicable certification criteria adopted by the Secretary, and the resultant combination also meets the requirements included in the definition of a Qualified EHR.
  2. Qualified EHR. An electronic record of health-related information on an individual that:
    1. Includes patient demographic and clinical health information, such as medical history and problem lists; and
    2. Can provide clinical decision support; to support physician order entry; to capture and query information relevant to health care quality; and to exchange electronic health information with, and integrate such information from, other sources.
  3. EHR Module: Any service, component, or combination thereof that can meet the requirements of at least one certification criterion adopted by ONC.
  4. Complete EHR: EHR technology that has been developed to meet all applicable certification criteria adopted by the Secretary.

Eligible Professionals

  • Hospital-based eligible professionals are not eligible for incentive payments. An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient (Place Of Service code 21) or emergency room (Place Of Service code 23) setting.
  Medicare Medicaid
Providers
  • Doctor of medicine or osteopathy
  • Doctor of oral surgery or dental medicine
  • Doctor of podiatric medicine
  • Doctor of optometry
  • Chiropractor
  • Physician
  • Dentist
  • Certified nurse-midwife
  • Nurse Practitioner
  • Physician assistant practicing in a FQHC or RHC led by a physician assistant
Settings
  • If Medicaid settings do not apply
  • 30% of services furnished to Medicaid patients in an outpatient setting; or
  • A pediatrician with 20% of services furnished to Medicaid patients in an outpatient setting
Other Conditions
  • If neither of the Medicaid settings apply AND the needy individual** patient volume requirements to the right is not met, then the provider must have billed the Medicare Physician Fee Schedule for patient services
  • If neither of the above settings apply then did the professional practice predominantly in an FQHC or a RHC with a 30% needy individual** patient volume threshold?

**Section 1903(t)(3)(F) of the Act defines needy individuals as individuals meeting any of the following three criteria: (1) They are receiving medical assistance from Medicaid or the Children's Health Insurance Program (CHIP); (2) they are furnished uncompensated care by the provider; or (3) they are furnished services at either no cost or reduced cost based on a sliding scale.

Eligible Hospitals

  Medicare Medicaid
Hospitals
  • "Subsection (d) hospitals" in the 50 states or DC that are paid under the Inpatient Prospective Payment System (IPPS)
  • Critical Access Hospitals (CAHs)
  • Medicare Advantage (MA-Affiliated) Hospitals
  • Acute care hospitals (including CAHs and cancer hospitals) with at least 10% Medicaid patient volume
  • Children's hospitals (no Medicaid patient volume requirements)