2016 was the last year to begin participation in the Medicaid EHR Incentive Program

Provider Requirements

Provider Types:

  • Physicians, Nurse Practitioners, Dentists, FQHCs, Optometrists, and Pediatricians (20 percent minimum Medicaid patient volume)

Patient Volume Requirements:

  • 30% Medicaid patient volume
  • Patient volume look-back period is the preceding calendar year
  • Volume may be established by individual provider or by the group

Active Enrollment:

  • Medicaid provider is active in NJMMIS
  • For more information on NJMMIS click here

Provider Level:

  • EP attested through another organization, can  reassign incentives to current organization through CMS EHR Incentive Program portal
  • EPs who began participation in CY 2016 or prior  are eligible for remaining MU incentives through CY 2021
  • Payment may be made to the individual provider or the group

Note: Hospital-based EPs are generally not eligible to participate in the EHR Incentive Programs. The only exception is that Medicaid EPs practicing predominatly in an FQHC or RHC are not subject to the hospital-based exclusion.

EHR Requirements

Proof of a 2014 or 2015 Edition CEHRT

Modified Stage 2:

  • 2014 Edition CEHRT
  • 2014/2015 Edition CEHRT
  • 2015 Edition CEHRT
  • EHR technology must support the objectives and measures to which EP plans to attest

Stage 3

  • 2015 Edition CEHRT
  • 2014/2015 Edition CEHRT (CMS is adopting final policies to allow healthcare providers to use 2014 CEHRT, 2015 CEHRT or 2014-2015 combination CEHRT)
  • EHR technology must support the functionalities, objectives and measures for Stage 3

Click here for more information on certified EHR

50/80 Rule

50% Rule – To be a meaningful EHR user, an EP must have 50% or more of their patient encounters during the EHR reporting period at a practice/location or practices/locations equipped with certified EHR technology. (There are additional considerations to determine eligibility for part-time employees for MU if working at multiple practices/locations. Click here for more information).

80% Rule – Measures that encompass all patients have a threshold of 80%, then at least 80% of all the patients’ records must be maintained using certified EHR technology otherwise the EP, eligible hospital or CAH could not possibly meet the threshold.

New Jersey Innovation Institute
NJIT 400 Fenster Hall
323 Dr Martin Luther King Jr Blvd
Newark, NJ 07102


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