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Medicaid State Information

The Centers for Medicare & Medicaid Services (CMS) is renaming the EHR Incentive Programs to the Promoting Interoperability (PI) Programs to continue the agency’s focus on improving patients’ access to health information and reducing the time and cost required of providers to comply with the programs’ requirements. CMS is also in the process of finalizing updates to the programs through rulemaking. For more information, visit the landing page where CMS will publish updates and additional resources as soon as they are available.

All states and territories offer the Medicaid PI Program (formerly the EHR Incentive Program) voluntarily, and determine program milestones, such as attestation timelines and reporting periods.

For more information regarding Medicaid state/territory links, please click here

Who can participate in the Medicaid PI Program?

Eligible Professionals (EPs)

EPs* in the Medicaid PI Program include:

  • Physicians (primarily Doctors of Medicine and Doctors of Osteopathy)
  • Nurse Practitioner
  • Certified Nurse-Midwives
  • Dentists
  • Physician Assistant who provide services in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) led by a Physician Assistant.

*Note: In certain states, Optometrists are eligible for the Medicaid PI Program.  For an Optometrist to be eligible, the state Medicaid program must cover adult Optometry services under physician services in the Medicaid State Plan.  Please check with your state Medicaid agency for more information

To qualify for a Medicaid Incentive Payment, an EP must also meet one of the following criteria:

  • Have a minimum 30 percent Medicaid patient volume
  • Be a Pediatrician* and have a minimum 20 percent Medicaid patient volume
  • Practice predominantly in a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) and have a minimum 30 percent patient volume attributable to needy individuals

Review this table for more information on the payment schedule for EPs participating in the Medicaid PI Program from 2011 – 2021.

Eligible Hospitals

For more information on which hospitals can receive a Medicaid EHR incentive payment, click here.

Additional Information for EPs and Eligible Hospitals Participating in the Medicaid PI Program:

  • The program is administered voluntarily by states and territories, and will pay incentives through program year 2021.
  • EPs are eligible for incentive payments for up to 6 years, and participation years do not have to be consecutive.
  • The last year that a health care provider could begin participation was 2016.
  • Incentive payments for EPs under the Medicaid PI Payments can amount to up to $63,750 over 6 years.
  • Health care providers could have received an incentive payment for adopting, implementing, or upgrading certified EHR technology in their first year of participation.
    • In subsequent years, health care providers can receive incentive payments for successfully demonstrating meaningful use.
  • Health care providers who also treat Medicare patients may also be required to participate in the CMS Quality Payment Program, which is separate from the PI Program. For more information, please visit QPP.cms.gov.
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