Lots of $ in electromyoneurography (ECS) for PTs ?

[greco13]

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Can anyone speak to how lucrative doing electrodiagnostic studies / electromyoneurography can be as a PT, ECS? I've heard some crazy numbers thrown out in verbal conversations among PTs in this specialty but haven't gotten very far trying to research this on my own.

 

[keyboardmouse]

Can anyone speak to how lucrative doing electrodiagnostic studies / electromyoneurography can be as a PT, ECS? I've heard some crazy numbers thrown out in verbal conversations among PTs in this specialty but haven't gotten very far trying to research this on my own.

what figures did you hear?

 

[greco13]

what figures did you hear?

I tried to research the codes for various tests and search for them in the CMS physician fee schedule but pretty much just got lost in a whirlwind of acronyms; didn't really know what I was looking for. I had one ECS, who works part time for a group of neurologists, tell me they are billing about $650/visit and he is earning about half that considering it is the neurologists' practice and all he pretty much does is show up, test patients, and complete the notes. I guess what I am really looking for is confirmation of these numbers and to get an idea of the $ these PTs are making who are doing it full time and/or independently.

 

[keyboardmouse]

Can OTs do this too?

 

[Azimuthal]

Can OTs do this too?

That's a negative.

 

[greco13]

Can anyone speak to how lucrative doing electrodiagnostic studies / electromyoneurography can be as a PT, ECS? I've heard some crazy numbers thrown out in verbal conversations among PTs in this specialty but haven't gotten very far trying to research this on my own.

Looks like medicare is reimbursing ~$340 per bilateral study. I observed a PT,ECS a couple weeks ago; he did 3 bilateral studies in <3hrs. Let's say I worked a VERY conservative 40 weeks/year, 5 days/week, 8hrs/day, 6 tests/day (leaving time for study interpretation/notes) = $408,000 in reimbursement. Same scenario doing 8 tests/day = $544,000. Or how about 45 weeks/year, 5 days/week, 8 tests/day = $612,000.

From what I can tell, this specialty is quite difficult to get into. There is, however, 1 ABPTS approved residency: http://www.emgncv.net/emg-ncv-course/

 

[jblil]

Is there enough demand to keep a PT busy full-time doing this, assuming one lives in a large metro area? At my school, we had a couple of classes on nerve conduction velocity and actually played with the instruments. Interesting stuff, but I think it'd get boring real quick. Although, for half a mil a year, I guess I could stand the boredom!

 

[Mad Jack]

Is there enough demand to keep a PT busy full-time doing this, assuming one lives in a large metro area? At my school, we had a couple of classes on nerve conduction velocity and actually played with the instruments. Interesting stuff, but I think it'd get boring real quick. Although, for half a mil a year, I guess I could stand the boredom!

You'd be putting yourself in a very bad position should reimbursement change down the line if this was your entire business model.

 

[Azimuthal]

From what I've seen, most places don't put all their eggs in EMG studies. The one clinic I saw also had ground reaction plates, etc. and was a highly specialized gait/running clinic.

 

[Bluecase]

Trying to calculate salary based off of reimbursement rates is not possible. There are so any other factors that go into a persons salary that chip away at those rates.

Also keep in mind that in major cities doctors (pmr, neurologists, etc...) perform ncv/emgs because their offices have the capital to purchase the expensive equipment. My guess is it's also regional whereas only rural PTs could find the demand to do an ncv if there were no other options.

That being said I have never met or heard of any PTs doing them, and my patients don't get them often at that. This profession is not about being rich-it's about finding something you enjoy doing and helping people while making a comfortable living.

 

[DesertPT]

Is there enough demand to keep a PT busy full-time doing this, assuming one lives in a large metro area?

Based on my limited knowledge and experience, I seriously, seriously doubt it.

 

[greco13]

Trying to calculate salary based off of reimbursement rates is not possible. There are so any other factors that go into a persons salary that chip away at those rates.

Also keep in mind that in major cities doctors (pmr, neurologists, etc...) perform ncv/emgs because their offices have the capital to purchase the expensive equipment. My guess is it's also regional whereas only rural PTs could find the demand to do an ncv if there were no other options.

That being said I have never met or heard of any PTs doing them, and my patients don't get them often at that. This profession is not about being rich-it's about finding something you enjoy doing and helping people while making a comfortable living.

It is impossible to calculate salary based off reimbursement.

Unfortunately I primarily only have word-of-mouth info for a lot of what I've learned about PTs doing ENMG, albeit from guys who have each done 20-30k studies and are leaders in the field.

There are only 163 ABPTS certified ECS PTs in the US, the majority being east of the Rockies. ECS certification is required by CMS for reimbursement as a PT. That number isn't expected to grow (or so I've been told) because many of these specialists were trained in ENMG while in the uniformed services (primarily Army, Navy, PHSCC) and many of their ENMG residencies have since died out. There are a lot of hurdles to jump to get into it e.g. training/mentorship, certification, hardware/software costs, physician referral sources, state practice acts. Supposedly at some point there was a sudden decrease in reimbursement for ENMG and so a lot of physicians started referring out more - again just word-of-mouth.

Here are just a few examples of PTs:

http://neurocareedx.com/meet.html (near Sacramento)

http://www.tidewaterpt.com/locations/dover/ (near DC)

https://mybraindoctors.com/meet-our-doctors (small town Utah)

There's also this DSc in clinical electrophysiology: http://rmuohp.edu/academics/dsc_clinical_electrophysiology/

You can find more PT, ECS info here:

http://www.abpts.org/apta/directories/abpts.aspx?navid=10737423513

http://www.aptasce-wm.org

http://www.enmgcongress.org

http://www.abpts.org/Certification/SpecialtyCouncil/ClinicalElectrophysiology/

http://www.abpts.org/uploadedFiles/ABPTSorg/About_ABPTS/Statistics/CertificationbyYear.pdf

http://www.abpts.org/uploadedFiles/...istics/CertifiedSpecialistsbyState_Number.pdf

http://www.abpts.org/uploadedFiles/ABPTSorg/About_ABPTS/Statistics/RecertifiedSpecialistsbyArea.pdf

http://www.abpts.org/uploadedFiles/ABPTSorg/About_ABPTS/Statistics/CertifiedSpecialistsbyState.pdf

 

[greco13]

Based on my limited knowledge and experience, I seriously, seriously doubt it.

Wrong.

 

[greco13]

True, Mad Jack.

 

[DesertPT]

Wrong.

Ok just because its theoretically possible doesn't mean it is going to be a widely available avenue for most PTs. Its not realistic to plan on this being your whole business. That was the point.

 

[greco13]

Ok just because its theoretically possible doesn't mean it is going to be a widely available avenue for most PTs. Its not realistic to plan on this being your whole business. That was the point.

It's not a theory. PTs are, indeed, filling their schedules exclusively with ENMG in large metro areas. Your doubt has been resolved. That's the point.

 

[DesertPT]

It's not a theory. PTs are, indeed, filling their schedules exclusively with ENMG in large metro areas. Your doubt has been resolved. That's the point.

Do you think it is a pretty realistic option for most PTs/PT students in large metro areas to plan on going into if they are interested? As in, is there a high probability of gaining reliable employment or employing yourself with exclusively ENMG? This is the point I was trying to get at, not all this mincing of words. It is something I am somewhat interested in so I'm curious.

 

[greco13]

Do you think it is a pretty realistic option for most PTs/PT students in large metro areas to plan on going into if they are interested? As in, is there a high probability of gaining reliable employment or employing yourself with exclusively ENMG? This is the point I was trying to get at, not all this mincing of words. It is something I am somewhat interested in so I'm curious.

I suppose I'll repost a couple of my previous comments here for your convenience: "From what I can tell, this specialty is quite difficult to get into.", "There are a lot of hurdles to jump to get into it e.g. training/mentorship, certification, hardware/software costs, physician referral sources, state practice acts."

 

[keyboardmouse]

Any more info on this?

 

[dylanh]

had one ECS, who works part time for a group of neurologists, tell me they are billing about $650/visit and he is earning about half that considering it is the neurologists' practice and all he pretty much does is show up, test patients, and complete the notes.

sounds good

 

[saywuh]

does EMG require certification for a PT to be able to do them?

 

[SloanTriumph]

Yes I'm sure it does.