Eligible Professionals - Incentive Payments

Eligible Professionals can receive up to $63,750 over six years. Pediatricians who qualify with a 20 percent Medicaid patient volume receive two-thirds of the maximum incentive payment, totaling $42,500. Pediatricians who qualify with a 30 percent Medicaid patient volume can receive the full incentive payment.

Eligible Professionals may participate in non-consecutive years. The last year for an Eligible Professional to begin to receive payments in the Medicaid EHR Incentive Program is 2016. Program Year 2021 is the last year a participant may receive an incentive payment.

Eligible Professionals may receive an incentive payment from either Medicaid or Medicare, but not both. A Medicaid Eligible Professional may receive an incentive payment from only one state in a Payment Year.

Eligible Professionals may assign an incentive payment to either themselves or the group practice designated by the “Pay to” address on their Wisconsin Medicaid provider file (found in the demographics section in the ForwardHealth Portal). Eligible Professionals are responsible for maintaining this information.

Eligible Professional Incentive Payment Schedule

Payment Year

Payment Amount (30 Percent Medicaid Patient Volume)

Reduced Payment Amount for Pediatricians (20 Percent Medicaid Patient Volume)

Year 1

$21,250

$14,167

Year 2

$8,500

$5,667

Year 3

$8,500

$5,667

Year 4

$8,500

$5,667

Year 5

$8,500

$5,667

Year 6

$8,500

$5,667

Total

$63,750

$42,500

Last Revised: April 28, 2016