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 set an appointment. This is about a business opportunity, not just CEU courses.

The Physical Therapy Practice Act of the State of New Jersey defines Physical Therapy as:

“Physical therapy” and “physical therapy practice” mean the identification of physical impairment or movement-related functional limitation that occurs as a result of injury or congenital or acquired disability, or other physical dysfunction through examination, evaluation and diagnosis of the physical impairment or movement-related functional limitation and the establishment of a prognosis for the resolution or amelioration thereof, and treatment of the physical impairment or movement-related functional limitation, which shall include, but is not limited to, the alleviation of pain, physical impairment and movement-related functional limitation by therapeutic intervention, including treatment by means of manual therapy techniques and massage, electro-therapeutic modalities, the use of physical agents, mechanical modalities, hydrotherapy, therapeutic exercises with or without assistive devices, neurodevelopmental procedures, joint mobilization, movement-related functional training in self-care, providing assistance in community and work integration or reintegration, providing training in techniques for the prevention of injury, impairment, movement-related functional limitation, or dysfunction, providing consultative, educational, other advisory services, and collaboration with other health care providers in connection with patient care, and such other treatments and functions as may be further defined by the board by regulation.

It is unfortunate that a physical therapist is not permitted to perform NCV or needle EMG pursuant to the New Jersey Board of Medical Examiners regulation N.J.A.C. 13:35-2.6(c)1.

According to the above a PT would not be able to perform needle EMG or NCV Independently. Musculoskeletal Ultrasound Imaging are not invasive studies as there is no penetration of the integrity of the skin and not mentioned in above ruling.

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*.

call 888-447-6014 ext 1 and we will help you calculate the possible:

  • Total Reimbursement Patient & ROI (Return On Investment) For You!
  • How You Can Get Started Being Reimbursed for Diagnostics NOW

*This fee schedule was 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.”