Many physical therapists think that they can not perform and get reimbursed for diagnostics tests. To address this question with facts, we are providing below excerpts of your State’s Practice Act and using Medicare as an example, show you possible reimbursements for four diagnostic tests.
If this piques your curiosity and you would like to discuss how you could implement diagnostics into your practice and start getting reimbursed quickly, please Click to access our calendar and set an appointment. This is about a business opportunity, not just CEU courses.
The Physical Therapy Practice Act of the State of Michigan defines Physical Therapy as
“Practice of physical therapy” means the evaluation of, education of, consultation with, or treatment of an individual by the employment of effective properties of physical measures and the use of therapeutic exercises and rehabilitative procedures, with or without assistive devices, for the purpose of preventing, correcting, or alleviating a physical or mental disability. Physical therapy includes treatment planning, performance of tests and measurements, interpretation of referrals, initiation of referrals, instruction, consultative services, and supervision of personnel. Physical measures include massage, mobilization, heat, cold, air, light, water, electricity, and sound. Practice of physical therapy does not include the identification of underlying medical problems or etiologies, establishment of medical diagnoses, or the prescribing of treatment.
It is unfortunate that the Michigan Legislature has indicated that Physical therapists are not allowed to perform needle EMGs, unless they are one of the three that were “grandfathered” in 2006.
According to the above a PT other than the ones grandfathered in 2006 would not be able to perform needle EMG. However, Nerve Conduction Studies are not invasive studies as they only involve surface electrodes. Other Electrodiagnostic studies such as Evoked Potential Studies (SSEP, VEP, BAERs) as well as Musculoskeletal Ultrasound Imaging are not invasive studies as there is no penetration of the integrity of the skin.
EMG/NCS Testing uses electricity and Musculoskeletal Ultrasound uses sound waves for the evaluation (testing and measurement) of the neuro-musculoskeletal system.
APTA fully supports PTs practicing EMG/NCS Testing as it is within the scope of Physical Therapy Practice. The Orthopedic Section of the APTA in a white paper not only advocates the use of Musculoskeletal Ultrasound Imaging within the scope of practice for Physical Therapy but also endorses its application both for diagnostic as well as procedural purposes to aid neuromuscular re-education, dry needling and electroneuromyography.
Find here information about Direct Access to Physical Therapy in your state.
Here is an example of a 2016 Medicare fee schedule for a variety of diagnostic testing for a selection of CPT codes and corresponding number of units. Insurances usually pay a multiple or a percentage of the medicare fee schedule*.
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We will help you calculate the possible:
• Total Reimbursement per Patient & ROI (Return On Investment) For You!
• How You Can Get Started Being Reimbursed for Diagnostics NOW
*This fee schedule were taken from the website of your regional Medicare Intermediary’s site around Sept. 2016 without modifier. Click here to view a Medicare Intermediary for your state. This fee schedule does not necessarily represent the exact amount of reimbursement you will receive as billing patterns and code selection varies. Please feel free to verify the current figures.”