Reprocessing Claims for Diagnostic Services by Certain PTs

Some Part B Medicare Administrative Contractors (MACs) denied valid claims submitted by Physical Therapists (PTs) in private practice:

  • For professional component or global code for certain CMS-designated diagnostic services involving electromyography, nerve conduction velocity, and sensory evoked potentials with technical component physician supervision indicators of 21, 66, 6A, 77, or 7A
  • Furnished by PTs in private practice certified in clinical electrophysiology by the American Board of Physical Therapy Specialties and providing these services in accordance with state law

MACs will reprocess these claims brought to their attention by PTs in private practice. Visit the Physician Fee Schedule website for related CMS payment policy and the applicable code list.