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Promoting Interoperability (PI)

The requirements and reporting information on this page are for the 2019 Medicare Promoting Interoperability (PI) Program. Beginning in 2019, all Medicare eligible hospitals, dual-eligible hospitals, and critical access hospitals (CAHs) are required to use 2015 edition certified electronic health record technology (CEHRT) and meet the new requirements outlined in the 2019 IPPS final rule.  

In 2019, all Medicaid-only eligible hospitals and eligible professionals (EPs) must attest directly to their state. Visit the 2019 PI Medicaid page for more information.

Latest News

  • 2019 Medicare Electronic Health Record (EHR) Program Eligible Hospital Reconsideration Application has been posted to the Payment Adjustment and Hardship Information page. The deadline for submitting all applications is December 21, 2018. The application can be accessed here.
  • On August 2, 2018, CMS released the Fiscal Year (FY) 2019 Medicare Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Long Term Care Hospital Prospective Payment System Final Rule. For more information on the upcoming changes for the 2019 program year, visit the Federal Register, and view this fact sheet.
  • Visit the Medicare PI Programs requirements for calendar year (CY) 2019 webpage which includes information on the new scoring methodology, CEHRT, and more. Information on 2019 program requirements for Medicaid will be available soon.
  • Now Available: CMS’ electronic clinical quality measure (eCQM) annual update for CY 2018 reporting. For more information, the updated measure specifications are available on the eCQI Resource Center for Eligible Hospitals, CAHs, and Eligible Clinicians.

Dates to Remember

January 1 December 31, 2018
  • 2018 PI Programs Reporting Year.
January 2, 2019
  • QualityNet system opens for eligible hospitals and CAHs attesting to CMS
  • Attestation period begins for CY 2018 PI Programs
February 28, 2019
  • Attestation period ends for PI Programs for CY 2018 reporting

Promoting Interoperability Programs Milestones

In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs (now known as the PI programs) to encourage clinicians, eligible hospitals, and CAHs to adopt, implement, upgrade (AIU), and demonstrate meaningful use of CEHRT.

Historically, the PI Programs consisted of three stages:

  • Stage 1 set the foundation for the PI Programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of health information.
  • Stage 2 expanded upon the Stage 1 criteria with a focus on advancing clinical processes and ensuring that the meaningful use of EHRs supported the aims and priorities of the National Quality Strategy. Stage 2 criteria encouraged the use of CEHRT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.
  • In October 2015, CMS released a final rule that modified Stage 2 to ease reporting requirements and align with other CMS programs. The final rule also established Stage 3 in 2017 and beyond, which focuses on using CEHRT to improve health outcomes.

For more information about Stage 1 and Stage 2, visit the Requirements for Previous Years page.

To continue our commitment to promoting and prioritizing interoperability of health care data, CMS renamed the EHR Incentive Programs to the Promoting Interoperability Programs in April 2018. This change will move the programs beyond the existing requirements of meaningful use to a new phase of EHR measurement with an increased focus on interoperability and improving patient access to health information.

Use the navigation bar on the left side of the website to learn more about the PI Programs, including program requirements for specific years, registration and attestation information, payment adjustment & hardship exceptions, clinical quality measures and more.

You can also stay up to date on the latest PI Program news and updates by following us on Twitter and by subscribing to the CMS PI Listserv.

Contact Information

  • Medicare EPs may contact the Quality Payment Program help desk for assistance at or 1-866-288-8292.
  • Medicaid EPs and hospitals participating in the Medicaid PI Program with inquiries about their participation should contact their State Medicaid Agencies.
  • Medicare and dually eligible hospitals participating in the Medicare and Medicaid PI Programs may contact the QualityNet help desk for assistance at or 1-866-288-8912.