CMS Pub. 100-22, ch. 2, § 50.1

Individual eligible professionals and group practices who choose to participate in the eRx

Incentive Program via the claims-based reporting mechanism do not have to enroll or

register to begin claims-based reporting of the eRx measure to CMS.

Participating eligible professionals or group practices who bill for the services or

procedures included in the denominator of the eRx measure report the corresponding

appropriate numerator G-code on their claim. Claims-based reporting may be via: (1) the

paper-based CMS 1500 Claim form or (2) the equivalent electronic transaction claim, the

837-P. The specifications for the eRx measure are available on the E-Prescribing

Measure section page of the CMS eRx Incentive Program website at

http://www.cms.gov/ERXincentive and may be updated on an annual basis.

The applicable G-code quality data must be reported on the same claim as the billable

service or procedure to which the QDC applies. The eRx measure does not require a

specific diagnosis to help determine the denominator; therefore, any diagnosis reported

on the claim is sufficient. The analysis algorithms that are used to determine whether an

eligible professional is a “successful electronic prescriber” match the QDCs to the service

and/or procedure codes on the claim. Thus, QDCs that are not submitted on the same

claim as the applicable service and/or procedure codes do not count toward an eligible

professional meeting the requirements of being a “successful electronic prescriber.”

Claims-based reporting is the only reporting mechanism available for purposes of

reporting on the eRx measure for the 2012 payment adjustment and for the 6-month

reporting periods for the 2013 and 2014 payment adjustments.

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