HCPCS G8553 And ERX Claims Updates

G8553 CPT that was used for eRx claims is no longer valid for claims billed dates of service 01/01/2014 and after.Individual eligible professionals and group practices participating in the eRx Group Practice Reporting Option (GPRO) who are not successful electronic prescribers will be subject to a 2.0% payment adjustment on their Medicare Part B services provided January 1, 2014 through December 31, 2014.To avoid the 2014 eRx payment adjustment, individual eligible professionals would have had to have been a successful electronic prescriber in 2012 and reported the G8553 CPT code via claims for at least 10 billable Medicare Part B PFS services provided January 1, 2013 through June 30, 2013.

Please review the 2014 eRx Payment Adjustment Information Fact Sheet for more detailed information, including how an eligible professional or group practice can request a hardship exemption to the 2014 eRx payment adjustment.

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