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March 22, 2012

Physical Therapists' Billing for EMG/NCV Studies

After careful consideration, CGS Medicare will allow Physical Therapists to bill the professional component of the EMG/NCV studies that they are allowed to perform in accordance with the requirements of the respective boards and statutes in Kentucky and Ohio. To bill for this component the therapist will need to execute a formal interpretation that is separate and distinct from the usual clinical notes. The interpretation should reflect the findings and an overview of how these findings helped direct the plan of care. This interpretation shall be made available upon request from a Medicare contractor.

CGS is approving this process retroactive to 01 January 2012. Any claims that were denied for the professional component and were submitted 01 January 2012 forward that meet the above requirements may be appealed using the redetermination process.

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