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Research Letter | Health Care Reform

Medicare’s Reimbursement Reduction for Nerve Conduction Studies Effect on Use and Payments

Brian C. Callaghan, MD, MS1,2; James F. Burke, MD, MS1,2; Lesli E. Skolarus, MD, MS1; Ryan D. Jacobson, MD1; Lindsey B. De Lott, MD1; Kevin A. Kerber, MD, MS1
[+] Author Affiliations
1University of Michigan, Ann Arbor
2VA Center for Clinical Management Research, Ann Arbor, Michigan
JAMA Intern Med. 2016;176(5):697-699. doi:10.1001/jamainternmed.2016.0162.
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This study examines whether a reduction in Medicare reimbursement for nerve conduction studies reduced the number of such studies conducted by health care professionals within a 1-year period.

To decrease health care costs, Medicare sought to identify overvalued Current Procedural Terminology (CPT) codes, including those with rapid volume growth, those submitted multiple times, or those submitted in conjunction with other codes.1 The codes for nerve conduction studies (NCS) met all 3 criteria.2 Electromyography (EMG) should typically be performed with NCS.3 Furthermore, EMG and NCS are part of the core residency training for neurologists and physiatrists but not for other health care professionals (physicians, podiatrists, physical therapists, nurse practitioners, and physician assistants). Medicare implemented a sharp reduction in reimbursement for NCS on January 1, 2013,4 but reimbursement for EMG was not changed. The effect of this policy on providers’ use of services and reimbursement payments for this is unclear.

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