Description
Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment.

Guidelines

  • CMS renamed the Electronic Health Record (EHR) Incentive Programs to the Promoting Interoperability (PI) Programs
  • Eligible professionals (EPs) should submit this modifier with services that are rendered in a dental health professional shortage area (HPSA) when the ZIP Code does not fully fall within that dental HPSA
  • This modifier does not affect payment or calculation of the geographic HPSA bonus
  • Important guidance from MLN Matters article MM7035:

"An EP who furnishes services predominantly in a HPSA is eligible for a 10 percent increase in the maximum EHR incentive payment amount, regardless of the type of HPSA in which the services were rendered. This means that any EP can perform services in any type of HPSA (primary care, mental health, or dental) and receive the increase in the maximum EHR HPSA incentive payment amount, as long as 50 percent or more of his/her services are performed in a HPSA. Note: This definition of an EHR HPSA provider is different from the definition for Medicare fee-for-service (FFS) HPSA bonus payments."

References

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department



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