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Are You Eligible?

Eligibility Requirements for Professionals

  • Incentive Payments for Eligible Professionals’ are based on the individual provider
  • Each provider is only allowed to receive 1 incentive payment per year
  • EP’s that perform 90% or more of their services in a hospital-based setting are not eligible
  • A provider can switch incentive programs only ONCE before 2015

* EP’s must have at least 30% Medicaid Patient volume in order to participate in the Medicaid incentive program (20% for Pediatricians)

Providers Eligible for Medicare Incentive Payment

Providers Eligible for Medicaid Incentive Payment

  • Doctor of Medicine or Osteopathy
  • Doctor of Dental Surgery or Dental Medicine
  • Doctor of Podiatry
  • Doctor of Optometry
  • Chiropractor
  • Physicians
  • Nurse Practitioners
  • Certified Nurse Mid-wife
  • Dentist
  • Physician Assistant (leads FQHC/RHC)

Eligibility Requirements for Professionals

Some hospitals may be able to receive an incentive payment from both Medicare and Medicaid.

* Acute Care Hospitals must have at least 10% Medicaid Patient volume in order to participate in the Medicaid incentive program

Hospitals Eligible for Medicare Incentive Payment

Hospitals Eligible for Medicaid Incentive Payment

  • Subsection D Hospitals
  • Critical Access Hospitals
  • Medicare Advantage Hospitals
  • Acute Care Hospitals
  • Children’s Hospitals