h1

Medicare issuing 2011 PQRS, eRx bonuses with “L” on RAs

November 20, 2012

The U.S. Centers for Medicare & Medicaid Services (CMS) has begun issuing its Medicare Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program bonuses for 2011—with payments noted on remittance advice using an “L” or “LE” modifier and, in some cases, shown as a negative amount, according to the AOA Advocacy Group.

An incentive payment is classified as a “levy”– that is, “a federally mandated payment,” — under CMS accounting terminology. Levies are indicated with an “L” reason code on remittance advice. An “LE” indicates the levy payment was made electronically, according to the CMS.

Typically, when an L or LE indicator appears on remittance advice, it represents a retraction to satisfy an Internal Revenue Service (IRS) tax levy or similar deduction from a payment, Palmetto GBA, the Medicare carrier for Ohio, South Carolina, and West Virginia, explains on its website.

For that reason, carrier accounting systems may place a negative sign before the dollar amount of a levy on a remittance notice. However, “in the case of PQRS and eRx incentive payments, the LE indicator represents an incentive payment and although the negative sign may appear on the remittance advice, the amount indicated does not represent a withhold or overpayment amount,” the Palmetto website continued. Both Medicare electronic and paper remittance advice provide additional coding to help practitioners identify PQRS and eRX incentive payments, the carrier noted.

For PQRS payments, eligible professionals will see the LE indicator to indicate an incentive payment, along with PQ11 to identify the payment as a 2011 PQRS incentive bonus. Additionally, paper remittance advice will read, “This is a PQRS incentive payment.” The year the incentive was earned will not be included in the paper remittance.

For eRx payments, eligible professionals will see the LE to indicate an incentive payment, along with RX11 to identify the payment as a 2011 eRx incentive payment. Additionally, paper remittance advice will read, “This is an eRx incentive payment.” Again, the year the incentive was earned will not be included in the paper remittance.

Medicare carriers began issuing 2011 PQRS and eRx incentive payments in October. AOA Advocacy Group representatives plan to meet with CMS officials over the coming weeks to discuss the way PQRS and eRx incentive payments are noted on remittance advice.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: