Medicare and Medicaid Differences
The chart below outlines the primary differences between the Medicare and Medicaid EHR Incentive Programs. All entries apply to both EPs and EHs, unless otherwise noted.
|Medicare EHR Incentive Program||Medicaid EHR Incentive Program|
|Run by CMS||Run by each state's Medicaid agency|
*EP payments occur over five consecutive years
EH payments occur over four consecutive years
*EP payments occur over six years (does not have to be consecutive years)
EH payments occur over three to six years (varies by state; does not have to be consecutive years)
|Program runs from 2011 through 2016||Program runs from 2011 through 2021|
|Payment adjustments begin in 2015 for eligible EPs/EHs who decide not to participate||No Medicaid payment adjustments|
|Must demonstrate MU every year to receive incentive payments||Can receive an incentive payment for adopting, implementing, or upgrading EHR technology in the first year; must continue to demonstrate meaningful use to receive incentive payments in subsequent years.|
|No patient volume requirement||Pediatricians must have a minimum Medicaid patient volume of 20 percent; all other EPs must have a minimum Medicaid patient volume of 30 percent. (EPs who practice predominately at a Tribal/Urban/FQHC/RHC may use a "needy individual" calculation to reach their 30 percent patient volume.)
EHs must have a Medicaid patient volume of at least 10 percent.
Learn how to calculate patient volume.
*EPs can receive up to $44,000 through the Medicare EHR Incentive Program over a five-year period or up to $63,750 through the Medicaid EHR Incentive Program over a six-year period.