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Who is eligible?

With the exception of dually-eligible hospitals, providers can only participate in one of the EHR Incentive Programs-Medicare or Medicaid-each year. To help determine which EHR Incentive Program is right for you, the following lists outline the key differences for eligibility between the Medicare and Medicaid EHR Incentive Programs.

  • Doctors of medicine or osteopathy
  • Doctors of dental surgery or dental medicine
  • Doctors of podiatry
  • Doctors of optometry
  • Chiropractors
  • "Subsection (d) hospitals" in the 50 states or DC that are paid under the Inpatient Prospective Payment System (IPPS)
  • Critical Access Hospitals (CAHs)
  • Medicare Advantage (MA-Affiliated) Hospitals
  • Physicians (doctors of medicine and doctors of osteopathy)
  • Nurse practitioners
  • Certified nurse-midwives
  • Dentists
  • Physician assistants who furnish services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant
  • Acute care hospitals (including CAHs and cancer hospitals) with at least 10% Medicaid patient volume
  • Children's hospitals (no Medicaid patient volume requirements)

If you represent a hospital that meets all of the following qualifications, you are dually-eligible for the Medicare and Medicaid EHR Incentive Programs:

  • You are a subsection(d) hospital in the 50 U.S. States or the District of Columbia, or you are a CAH; and
  • You have a CMS Certification Number ending in 0001-0879 or 1300-1399; and
  • You have 10% of your patient volume derived from Medicaid encounters.

We encourage potential participants to review CMS' flow chart  to learn more about the differences between the two EHR Incentive Programs.

For complete information on Eligibility Requirements for Professionals and Hospitals, visit the CMS Eligibility website https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/eligibility.html.

We encourage potential participants to review CMS' flow chart  to learn more about the differences between the two EHR Incentive Programs.

For complete information on Eligibility Requirements for Professionals and Hospitals, visit the CMS Eligibility website https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/eligibility.html.