Eligible hospital for Medicaid EHR program

by | Feb 23, 2012 | CPT modifiers

Medicaid EHR Eligible Hospitals

Hospitals eligible for Medicaid incentive payments are acute care hospitals, critical access hospitals, and children’s hospitals. Incentive payments to eligible hospitals are based on a formula in which a base incentive amount for all hospitals is modified by the number of Medicaid patient discharges, as well as other factors.

Acute Care and Critical Access Hospitals

  • Must have a Medicaid patient volume of at least 10% to be eligible to receive payments.

  • Must have a CMS Certification Number (CCN) with the last 4 digits of 0001 – 0879 or 1300 – 1399. These CCNs cover short-term general hospitals, cancer hospitals and critical access hospitals. Under the definition of the final rule, acute care hospitals and critical access hospitals must have an average length of patient stay of 25 days or fewer.

Children’s Hospitals

  • Do not have to meet a Medicaid patient volume threshold in order to be eligible.

  • Must have a CCN with the last 4 digits of 3300 – 3399.

NOTE: Some hospitals may receive incentive payments from both Medicare and Medicaid if they meet all eligibility criteria.