In Virginia, eligible Medicaid providers include physicians, nurse practitioners, certified nurse midwives, dentists and optometrists. In addition, physician assistants (PAs) providing care in a Federally Qualified Health Center led by a PA may be eligible.

To qualify, eligible providers must meet a minimum Medicaid patient volume threshold of greater than 30 percent. Pediatricians who have patient volumes between 20 and 30 percent are eligible for reduced incentives. Medicaid encounters volume can be calculated for an individual provider or for a group of providers. Providers will use calculations to determine if they are eligible to attest for EHR incentive payments.

Eligible hospitals include all children’s hospitals and hospitals with a minimum 10 percent Medicaid patient volume. Payouts to hospitals vary based on a number of factors with a base payment of $2 million.

Need help determining eligibility? Contact Physician Services today at 1-800-207-7928 or via email at