US · guidance
CMS Pub. 100-22, ch. 2, § 20.1
Individual Eligible Professionals
For purposes of the eRx Incentive Program, the definition of “eligible professional” is
identical to that for the Physician Quality Reporting System. An eligible professional is
any one of the following:
• Physician
o Doctor of Medicine
o Doctor of Osteopathy
o Doctor of Podiatric Medicine
4
o Doctor of Optometry
o Doctor of Dental Surgery
o Doctor of Dental Medicine
o Doctor of Chiropractic
• Practitioner
o Physician assistant
o Nurse Practitioner
o Clinical nurse specialist
o Certified registered nurse anesthetist (and Anesthesiologist Assistant)
o Certified nurse midwife
o Clinical social worker
o Clinical psychologist
o Registered dietitian
o Nutrition professional
o Audiologists (as of January 1, 2009)
• Therapist
o Physical therapist
o Occupational therapist
o Qualified speech-language therapist (began billing Medicare directly as of
July 1, 2009)
All Medicare-enrolled professionals in these categories are eligible to participate in the
eRx Incentive Program regardless of whether the professional has signed a Medicare
participation agreement to accept assignment on all claims. However, eligibility is
further restricted by scope of practice to those professionals who have prescribing
authority under their respective state practice laws.
History
(Rev. 10, Issued: 07-27-12, Effective: 10-29-12, Implementation: 10-29-12)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5d6dfe8e1ece8d514379937a7944921c24346516d8dba8d03fda9db2ed87a20f
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