Eligible Providers

For the Medicaid Electronic Health Record Incentive Program, a Medicaid-eligible professional (EP) is defined as a:

  1. physician
  2. nurse practitioner
  3. certified nurse-midwife
  4. dentist
  5. optometrist

NOTE: CMS also allows physician assistants who provide services in Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs) led by a physician assistant to participate. However, physician assistants need to be supervised in Maryland, so Maryland Medicaid effectively does not allow physician assistant participation.

 

Provider Qualifications

To qualify for Electronic Health Record incentive payment, a Medicaid-eligible professional must not be hospital-based and must meet one of the following criteria:

  • Have a minimum 30% Medicaid patient volume
  • Have a minimum 20% Medicaid patient volume, and is a pediatrician
  • Be a physician assistant who practices predominantly in a Federally-Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals

Hospital-based eligible professionals are defined as eligible professionals who furnish 90% or more of their services in either inpatient or emergency departments of a hospital. Hospital-based eligible professionals do no qualify for Medicare or Medicaid Electronic Health Record payments.

Eligible professionals may receive up to $63,750, available over six years. The first year's incentive payment is $21,250 and each subsequent year is $8,500.

Maryland Medicaid is no longer accepting applications for new Electronic Health Record Incentive Program participants. Program Year 2016 was the last year to begin participation.

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