You are an Eligible Professional (EP) if your professional services are paid under the Medicare Physician Fee Schedule (PFS). If you don't have 10 eRxs by June 30th and 25 by December 31, 2011, the
2012 eRx Payment Adjustment will reduce your payments from Medicare by 1%.
If you bill Medicare with the following codes, you will be subject to this rule: (CPT or HCPCS): 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109
However, you don't need to report if:
-- CPT codes above represent less than 10 percent of allowed Medicare charges in the first six months of 2011 (as a pediatrician, this is unlikely),
-- you have less than 100 claims for patient services with these visit and service codes for dates of service between January 1, 2011 through June 30, 2011.
More information (see Question #14).
