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February 2010 Client Newsletter


Highmark Medicare has now agreed that “Electronically Signed” signatures are now acceptable.

Medicare 2010 eRx Program

The 2010 program has some small changes from the 2009 program making it easier to participate.
· Only 1 code is now used: G8553: “At least 1 Rx created during the encounter was generated and transmitted electronically using the eRx system.”
· Only 25 or more unique visits (reporting the code 25 times) are required, with a minimum of “10% of an eligible professional’s Medicare Part B charges”. The codes counted include all of the office visit codes (99201-99215), plus Home, Rest Home, and Nursing Home visits.
· Still requires a “qualified electronic prescribing (eRx) system.”
· The G8553 MUST be submitted with the E&M code at the time it is billed for claims reporting. The G8553 cannot be sent at a later date and still count.
· Payment will be 2% of “allowed charges for professional services covered by Medicare Part B.” If you are also performing other testing in your office and billing globally (meaning both the technical & professional components), then we read this to mean that the 2% will not include the technical component portion of payments.

If you decide to participate, CPB (i.e., Rich) will need to know in advance so we can add the G8553 to your charge master and make sure the data entry staff are also aware. Clients for whom we maintain their charge form, we will add the code for you.

Please call with any questions.


The Therapy Cap for 2009 is $1,860 through December 31, 2010. However, as of January 28th, the Medicare Cap Exceptions process for independently practicing physical, speech and occupational therapists has not been extended beyond December 31, 2009. Our software is tracking each patient’s progress. Patients who near the Cap have the option of transferring their care to an outpatient hospital setting or signing an Advanced Beneficiary Notice and accepting responsibility for the balance.
2010 Client Newsletter Archive