December 20, APTA, the American Academy of Physical Medicine and
Rehabilitation, American Association of Neuromuscular & Electrodiagnostic
Medicine, and American Academy of Neurology met with Jonathan Blum, deputy
administrator and director of the Centers for Medicare and Medicaid Services
(CMS), to discuss cuts for electromyography/nerve conduction velocity (EMG/NCV)
services that will go into effect January 1, 2013. Other CMS officials attended
the meeting via videoconference.
from the 4 associations explained that the payment cuts to providers would be
between 40%-70%. APTA discussed the fact that most physical therapists (PTs)
who provide EMG/NCV do so exclusively (100% of their practice). Additionally,
many of these PTs serve patients in rural areas and often drive long distances
to treat them. Thus, the deep cuts could have a detrimental impact on patient
access to these services.
The associations requested that CMS phase in
the cuts over a 4-year period to allow time to revisit the values for NCV
studies before such draconian cuts become effective. Blum stated that CMS did
not have legal authority to do such a phase-in, nor would it be possible to
change the values for 2013; however, CMS would consider changing the
values for 2014.
stated that CMS is concerned with any effects that the reductions in payment
for EMG/NCV codes would have on Medicare beneficiaries. He said that CMS would
study the impact of the cuts over the next year. Blum continued that he would
be open to consulting with the organizations over the next month to identify
ways that CMS could track the impact, specifically through claims forms. If CMS
identifies a negative impact, the agency would likely take steps to calibrate
the payment differently for 2014. Further discussion related to NCV studies is
December 6, APTA sent an action alert urging association members to contact their members of Congress
about the scheduled payment cuts. Four days later, APTA and more than 120 other
organizations concerned about the impact of the 2013 cuts to reimbursement for
electrodiagnostic procedures sent a coalition letter to congressional
leadership and committees.