In-House EMG / NCS Testing

[greco13]

I'm a physical therapist board certified in clinical electrophysiology (more @ the bottom to answer FAQs). I do EMG/NCS full-time and I have provided over 4,000 studies to MDs/DOs at their practice locations. This has been a mix of “incident to” billing and being directly credentialed with payers (billing under my NPI).

1. Are podiatric physicians able to bill my services “incident to” ?

2. What are the most common reasons DPMs order EMG studies? e.g. insurance requires proof of polyneuropathy, to r/o lumbosacral radiculopathy, to evaluate for distal focal/mono neuropathies involving the leg/ankle/foot, other reasons?

3. If I approached you as a (DPM) private practice owner offering my services, what questions would you have for me?

Among all physical therapists in the United States, only 210 are board certified to provide electrodiagnostic (Edx) testing services. PTs who provide Edx testing are required to complete a rigorous didactic curriculum, 500 clinical studies and 2000 hours of testing to qualify to sit for an exam administered by the National Board of Medical Examiners (NBME). Studies show that EMG/NCS performed by PTs maintains the gold standard quality by having high compliance rates for following clinical practice guidelines. PTs who are board certified in EMG/NCS are recognized as qualified providers by major insurance carriers including Medicare and BCBS. Physical therapists have been recognized and listed by Medicare since 2001 as specifically qualified providers of Edx testing (CMS taxonomy code 2251E1300X). In over 50 years of EMG/NCS testing provided by PTs there has never been an insurance claim filed against a board-certified physical therapist providing Edx testing.

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[Scrantonicity]

I'm a physical therapist board certified in clinical electrophysiology (more @ the bottom to answer FAQs). I do EMG/NCS full-time and I have provided over 4,000 studies to MDs/DOs at their practice locations. This has been a mix of “incident to” billing and being directly credentialed with payers (billing under my NPI).

1. Are podiatric physicians able to bill my services “incident to” ?

2. What are the most common reasons DPMs order EMG studies? e.g. insurance requires proof of polyneuropathy, to r/o lumbosacral radiculopathy, to evaluate for distal focal/mono neuropathies involving the leg/ankle/foot, other reasons?

3. If I approached you as a (DPM) private practice owner offering my services, what questions would you have for me?

Among all physical therapists in the United States, only 210 are board certified to provide electrodiagnostic (Edx) testing services. PTs who provide Edx testing are required to complete a rigorous didactic curriculum, 500 clinical studies and 2000 hours of testing to qualify to sit for an exam administered by the National Board of Medical Examiners (NBME). Studies show that EMG/NCS performed by PTs maintains the gold standard quality by having high compliance rates for following clinical practice guidelines. PTs who are board certified in EMG/NCS are recognized as qualified providers by major insurance carriers including Medicare and BCBS. Physical therapists have been recognized and listed by Medicare since 2001 as specifically qualified providers of Edx testing (CMS taxonomy code 2251E1300X). In over 50 years of EMG/NCS testing provided by PTs there has never been an insurance claim filed against a board-certified physical therapist providing Edx testing.

1. I doubt it, but it may depend on the state.

2. Idiopathic dropfoot, tarsal tunnel syndrome, idiopathic neuropathy--those are the 3 most common I order them for.

3. I'm not an owner, but again I think it really depends on which state you're in--some states don't let podiatrists oversee physical therapists, P.A.'s, nurse practitioners, etc.

Congrats on the certification--I really didn't know physical therapists did those (though it looks like there are very few that do according to what you said). I thought it was just neurologists and physiatrists--learned something new...

 

[air bud]

Is there money to be made? Then some podiatrists will want your services. The "science" does matter....

 

[dtrack22]

Can’t be worse than the neurologist I have sent patients to where everything is tarsal tunnel. The Physiatrist I use doesn’t even perform the study, a tech does, he just interprets it and writes the report. His are better than the neurologists

 

[Shiyuan]

Small fiber nerve biopsy time 🤪🤪🤪

 

[CutsWithFury]

Can’t be worse than the neurologist I have sent patients to where everything is tarsal tunnel. The Physiatrist I use doesn’t even perform the study, a tech does, he just interprets it and writes the report. His are better than the neurologists

Same at my first hospital gig the physiatrist was way better at reading the report than the neurologist. I sent my EMGs to our physiatrist in the ortho clinic 95% of the time unless the patient was already established with the neurologist.

 

[AttackNME]

I'm a physical therapist board certified in clinical electrophysiology (more @ the bottom to answer FAQs). I do EMG/NCS full-time and I have provided over 4,000 studies to MDs/DOs at their practice locations. This has been a mix of “incident to” billing and being directly credentialed with payers (billing under my NPI).

1. Are podiatric physicians able to bill my services “incident to” ?

2. What are the most common reasons DPMs order EMG studies? e.g. insurance requires proof of polyneuropathy, to r/o lumbosacral radiculopathy, to evaluate for distal focal/mono neuropathies involving the leg/ankle/foot, other reasons?

3. If I approached you as a (DPM) private practice owner offering my services, what questions would you have for me?

Among all physical therapists in the United States, only 210 are board certified to provide electrodiagnostic (Edx) testing services. PTs who provide Edx testing are required to complete a rigorous didactic curriculum, 500 clinical studies and 2000 hours of testing to qualify to sit for an exam administered by the National Board of Medical Examiners (NBME). Studies show that EMG/NCS performed by PTs maintains the gold standard quality by having high compliance rates for following clinical practice guidelines. PTs who are board certified in EMG/NCS are recognized as qualified providers by major insurance carriers including Medicare and BCBS. Physical therapists have been recognized and listed by Medicare since 2001 as specifically qualified providers of Edx testing (CMS taxonomy code 2251E1300X). In over 50 years of EMG/NCS testing provided by PTs there has never been an insurance claim filed against a board-certified physical therapist providing Edx testing.

What comes to mind immediately is Dr Rodriguez. He's a podiatrist that does a lot of lower extremity nerve surgery. You might find some good feedback if you connect with him and/or his past fellows. Best of luck.

Dr. Rodriguez - Chicago Foot and Ankle Surgery | Our Staff | Edgardo Rodriguez, DPM | Dr. Roberto Segura

 

[newfeet]

1. I doubt it, but it may depend on the state.

2. Idiopathic dropfoot, tarsal tunnel syndrome, idiopathic neuropathy--those are the 3 most common I order them for.

3. I'm not an owner, but again I think it really depends on which state you're in--some states don't let podiatrists oversee physical therapists, P.A.'s, nurse practitioners, etc.

Congrats on the certification--I really didn't know physical therapists did those (though it looks like there are very few that do according to what you said). I thought it was just neurologists and physiatrists--learned something new...

Chiropractors can do them too. At least in my state.