avoird erx initiative reduction

oksanap

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Brooklyn, NY
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My provider is eligible profesional who is able to prescribe medications (i.e. he is psychatrist). But he does not prescribe medications at all. can we bill G8644 to avoid Medicare reduction? plese help us.
:confused:
 

ckkohler

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So, to clarify - your physician simply doesn't write prescriptions? I am not familiar with an M.D. who has prescribing privileges but chooses not to write them ... I've been researching on the CMS website for the code you state (G8644) .. the only thing I found about it is that this code is only to be used for eligible professional without prescribing rights - here's what I copied from the page

"Payment Adjustment: Another reporting option: When the eligible professional does not have prescribing privileges, report G8644 via claims. If this code is utilized, the eligible professional may not be considered for a payment adjustment."

I'm wondering if you even have the option to opt out??? Here's the link to the CMS website ...

https://www.cms.gov/apps/ama/licens...ureSpecifications_and_ReleaseNotes_101411.zip

Then you have to open the zip file ... hope this helps!
 

Lori Julian

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Bay City MI
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Are you saying that your provider enrolled for the eRx incentive but now you feel that he won't meet the threshhold? If I'm not mistaken, the deadline has passed to file for hardship on the basis that he won't prescribe enough encounters to qualify. I think that was last October for this reporting year. If he didn't sign up for the eRx incentive you shouldn't need to do anything at this point. It's only if you had signed up and won't meet the threshhold that you would have to be concerned about the 1% adjustments.

Lori Julian, CCS-P
 

oksanap

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No Dear colleges,
The issue is that my provider is MD but he does not prescribe medications. He works at facility and writes recommendations to facility personal on piece of paper. He does not prescribe medication as receipts . We had already received adjustment form Medicare. What can we do in this case to avoid future Medicare adjustments ? Thanks a lot!!!!!!
 
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