Reevaluation of EMG and Nerve Conduction Reimbursement by the Center for Medicare and Medicaid Services for the Calendar Year 2013

We, the undersigned, hereby resolve that the Center for Medicare and Medicaid Services should promptly reconsider changes to the payment policies and rates for physician services paid under the Medicare Physician Fee Schedule in calendar year 2013, particularly changes concerning reimbursement for EMG and Nerve Conduction Studies.

Implementing such cuts will lead to scaling back of private practices, layoffs and, most importantly, crippling limitationsto access for Medicare beneficiaries. In some cases, Medicare patients may not be seen at all by some physicians. Ultimately, this profoundly impairs a neurologist’s ability to treat other conditions as well, including Alzheimer’s, Parkinson’s, Multiple Sclerosis and Epilepsy.

The continued functioning of EMG labs across the country is vital to the health of countless patients with neuromuscular disease. For diseases such as Lou Gehrig’s disease and carpal tunnel syndrome, the EMG and Nerve Conduction studies are necessary and indispensible tests for diagnosis. In many cases, technical costs of starting an EMG lab can exceed 50,000 dollars, requiring adequate compensation for time spent evaluating, diagnosing and treating this important patient population.

Academic practices depend on EMG’s and Nerve Conduction Studies as the lifeblood of neuromuscular departments. These departments fund research efforts that ultimately develop more robust treatment options for diseases such as muscular dystrophy and Guillain Barre syndrome, among many others. The payments cuts set to be implemented would severely impair the continued research, evaluation and treatment of these patients., including the ever-growing community of Medicare beneficiaries who already face challenges in access to care.

We hereby urge the CMS to reconsider the previous ruling on November 1st, 2012 as it pertains to proposed cuts in EMG and Nerve Conduction Studies. We would further recommend that the CMS reevaluate the recommendations set forth by the American Medical Association’s Relative Value Scale Update Committee, which has a proven track record of balancing the desire to advocate for fair compensation for physicians with the need to preserve Medicare and Medicaid as cost effective enterprises.


Andrew Wae Wong, MD



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    Rey Cantu, United States

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    John Plourde, United States

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    Robert Jensen, MD, United States

    1 year ago Comments: If current cuts remain in place, as of 1/1/2014, I will have to cease taking Medicare patients for evals and any EMG/NCS studies, as the current reimbursement is below my overhead costs. This is going to severely limit Medicare patients' access to these studies and our lab, which will likely increase downstream costs significantly for Medicare patients. It's too bad that those individuals that are 65+, and were gainfully employed throughout their lives (paying into Medicare for 40+ years), will not be able to be appropriately diagnosed, and therefore will suffer delays in treatment, unnecessary surgical interventions, and associated costs for other testing (MRI, CT, etc.) that could be avoided with proper EMG/NCS testing.
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