US · guidance
CMS Pub. 100-22, ch. 2, § 20.1.2
Professionals Not Eligible to Participate
Providers and professionals not defined as eligible professionals are not eligible to
participate in the eRx Incentive Program do not qualify for an incentive, and are not
subject to a payment adjustment. Services payable under or based on fee schedules or
methodologies other than the PFS are not included in the eRx Incentive Program (for
example, services provided in federally qualified health centers, independent diagnostic
testing facilities, portable x-ray suppliers, independent laboratories, hospitals [including
critical access], rural health clinics, ambulance providers, and ambulatory surgery center
facilities). In addition, suppliers of durable medical equipment (DME) are not eligible for
the eRx Incentive Program since DME is not based on or paid under the PFS.
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
408143b7fc419c17ca4d8ba52dca0614689410f3c5f534f269eeba05a29f5ec2
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