Online only: Providers that can’t e-prescribe must act quickly to avoid the 1.5% pay cut

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article is for clinicians, practice managers, coders, and billing staff who need to understand Medicare’s e-prescribing deadline and the steps involved in avoiding a payment adjustment. It covers the general e-prescribing requirements, how reporting is handled on a claim, the role of covered prescription types, and the basic process for requesting an exemption through the CMS portal. The discussion is focused on compliance timing, eligibility for exemptions, and administrative filing considerations.

Why This Topic Matters

Missing the e-prescribing requirement can affect Medicare reimbursement, so practices need to know whether they must report compliance or pursue an exemption before the deadline.

What You Will Learn

  • The general Medicare e-prescribing deadline requirements
  • How e-prescribing compliance is reported on a claim
  • Which prescription types may be included in e-prescribing reporting
  • When a hardship exemption may be considered
  • How the exemption request process is handled administratively

Who Should Read This

  • Clinicians
  • Practice managers
  • Medical coders
  • Billing staff
  • Compliance staff

Codes Discussed


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