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  • APTA Advocacy for EMG, Other Diagnostic Services Results in Payment Clarification from CMS

    Good news for physical therapists (PTs) certified by the American Board of Physical Therapy Specialties in electrophysiologic physical therapy: the US Centers for Medicare and Medicaid Services (CMS) has stated in no uncertain terms that those PTs are permitted to perform certain diagnostic services without the need for physician supervision where those services are allowed by state law. The announcement was made after APTA and other stakeholders pressed the agency to clear the air in order to end payment reductions or outright denials to PTs providing the services.

    According to the CMS statement, board-certified clinical specialists in electrophysiology physical therapy are qualified to provide services involving electromyography (EMG), nerve conduction velocity (NCV), and sensory evoked potentials (SEPs) without physician supervision, and should be paid for those services. It's a provision that's been around since 2001, according to CMS; however, the message wasn't always getting through to some Medicare Administrative Contractors and other payers, who would pay only for the technical component of the service, for some codes but not others, or nothing at all.

    In its statement, CMS reminds stakeholders that it assigns a Physician Supervision Indicator (PSI) of “09” to its collection of PT-designated diagnostic services codes, making it clear that physician supervision is not required for the global and professional component codes of these services.

    "APTA was concerned when it became clear to us that PTs weren't receiving appropriate recognition for these services, but grateful that the issue could be resolved through clear communications from CMS," said Kara Gainer, APTA director of regulatory affairs. "We hope that this statement will erase all doubts about whether a qualified PT can receive full payment for the delivery of services that have been permitted for nearly 2 decades."

    Comments

    • This is amazing news and congrats to APTA, ACEWM and those a few PTs such as Elaine Armantrout, John Palazzo and a few others who worked very hard for this. The time is now to expand the scope of practice of Physical Therapy to fully expand in the performance and ordering of diagnostic testing such as EMG/NCS, Musculoskeletal Ultrasound and others. Let's work together for an awesome future for PTs Beyond 2020.

      Posted by Dimitrios Kostopoulos, DPT, MD, PhD, DSc, ECS on 10/17/2018 5:59 PM

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