NY Medicaid EHR Incentive Program

Participation Checklist


Eligible Professionals (EPs) must complete the federal registration prior to attesting with the NY Medicaid EHR Incentive Program. Although federal registration at CMS is required before attesting, it is most efficient to have the NYS requirements in place prior to that step. The following tasks are required to be maintained for each participation year in order to maintain eligibility:

  • Be an eligible provider type
  • Not be hospital–based
  • Medicaid Enrollment
  • ETIN Association
  • CMS Registration

EPs who are in their first participation year of the program must meet all eligibility requirements. EPs must also adopt, implement, or upgrade to a certified EHR system to be eligible for the first incentive payment.

✓ Eligible Provider Types

The following types of healthcare practitioners are eligible to apply for the NY Medicaid EHR Incentive Program

  • Physicians* (M.D. and D.O.)
  • Nurse Practitioners
  • Certified Nurse Midwives
  • Dentists
  • Physician Assistants who practice in a Federally Qualified Health Center (FQHC) that is led by a Physician Assistant or Rural Health Clinic that is led by a Physician Assistant

*Pediatricians have the reduced option of demonstrating 20–30% Medicaid patient volume, but will only receive 2/3 the incentive payment when their percentage is below 30%.

✓ Not be Hospital–Based Practitioners

To be eligible to receive the NY Medicaid EHR Incentive, the healthcare practitioner must not be "hospital–based." Hospital–based practitioners are defined by CMS as those practitioners who furnish 90% or more of their covered professional (i.e., Medicaid) services in the hospital inpatient and emergency department (defined as services that would be identified using place of service (POS) codes 21 and 23 on HIPAA–standard transactions).

Note: This percentage is based on the entire calendar year prior to the payment year.

✓ Medicaid Enrollment

NYS Department of Health (DOH) now requires all billing providers to sign up for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) or PDF Remittance Advice. Existing enrolled providers have begun receiving notices with their yearly Certification Statement, indicating (based on their existing enrollment information) whether they need to complete and submit the EFT and/or ERA/PDF forms in addition to submitting the signed and notarized Certification Statement. For additional information please review the 10/25/2013 eMedNY Newsletter Update outlining this guidance.


Providers are required to revalidate according to 42 CFR 424.515. Revalidation is the process for providers to resubmit and recertify their enrollment status with NY Medicaid. The purpose is for NY Medicaid to maintain accurate and up–to–date information for providers. Providers who do not revalidate are subject to their Medicaid enrollment being terminated. Once terminated, providers would not be eligible to participate in the NY Medicaid EHR Incentive Program. If a provider or the assigned payee is terminated prior to payment approval of an attestation, the incentive payment would not be paid. NYS DOH sends out reminder letters when providers need to revalidate their enrollment. For more information regarding revalidation, please visit emedny.org.

✓ ETIN Association

The Electronic Transmitter ID Number (ETIN) is a billing code that allows the electronic submission of New York Medicaid claims for Providers as well as for checking eligibility. A provider can either be associated to a personal ETIN or the ETIN of a larger Medical institution, and to several at one time. If a provider is not already associated to an ETIN, he/she can apply for his/her own individual ETIN or can associate to a preexisting ETIN of a group/ hospital.


ePACES is a free, web–based application available to NY Medicaid providers to submit electronic transactions including claims submission, eligibility verification, prior approvals, and MEIPASS access. The ePACES account username and password are used to log in to MEIPASS and also grants other users access privileges to attest on your behalf. It is possible to assign a single user to do the MEIPASS attestation for more than one provider. As long as each provider has certification for the same ETIN that is registered with an ePACES account, then one user may access MEIPASS and do multiple attestations.

✓ CMS Registration

A provider can only choose either the Medicaid EHR Incentive or the Medicare EHR Incentive. The choice to enroll in the Medicaid incentive is made by registering for the EHR Incentive on the Centers for Medicare and Medicaid Services (CMS) and selecting the Medicaid EHR Incentive.

When providers register on CMS they can elect where their incentive payment will be assigned, what contact information will be provided in the MEIPASS information, and what ONC (Office of the National Coordinator) certified EHR technology the provider is electing to use.