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  • Professional Component of EMG Now Billable by PTs in MAC Jurisdictions H, L

    Qualified physical therapists in jurisdictions H and L, under the Medicare Administrative Contractor (MAC) Novitas Solutions, now can perform and bill for both the technical and professional components of electromyography (EMG). The MAC's policy revision, which brings it into alignment with national Medicare policy, is the result of APTA's advocacy efforts.

    Jurisdiction L covers Pennsylvania, New Jersey, Maryland, Delaware, the District of Columbia, and certain counties of Virginia (Arlington, Alexandria, and Fairfax); Jurisdiction H covers Arkansas, Louisiana, Mississippi, Colorado, New Mexico, Oklahoma, and Texas. The revisions are to local coverage determinations (LCDs) L29547 and L32723 for nerve conduction studies and EMG.

    Previously, the LCD policies stated that physical therapists could bill only for the technical component of EMG services. However, APTA sent a reconsideration letter expressing our concerns with the policies and urging Novitas Solutions to revise the language so that it would be consistent with national Medicare policy. APTA staff received correspondence from Novitas Solutions that these LCDs will be revised shortly to allow qualified physical therapists to perform and bill for both the technical and professional components of EMG services.

    Novitas Solutions has indicated that the updated LCDs will be on its website soon. For questions or more information, please e-mail advocacy@apta.org.