More primary care doctors could qualify for Medicare bonuses

NEWS IN BRIEF — Posted Feb. 28, 2011

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The Centers for Medicare & Medicaid Services has changed the eligibility requirements for Medicare primary care incentives to include more newly enrolled physicians.

Starting this year, primary care physicians will earn quarterly bonuses equal to 10% of the primary care services they provide under Medicare Part B. CMS defines a primary care doctor as having a specialty designation of family practice, internal medicine, pediatrics or geriatrics. Nurse practitioners and physician assistants are eligible for bonuses, too.

Under the rule change, newly enrolled primary care physicians no longer will have to participate in the Medicare program for two years before they can start earning bonuses.

Physicians and others receiving the bonuses must have 60% of their services as primary care. For 2011 bonuses, CMS had been looking at the 2009 billing year to determine if doctors met this threshold. But under the recent rule change, the Medicare agency also will look at the preceding year's claims data when determining if a newly enrolled physician meets or exceeds the 60% mark.

Note: This item originally appeared at

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