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EMG State Laws

It is the AANEM’s position that only physicians who have proper training in electrodiagnostic (EDX) medicine should perform EDX testing. In addition, only a residency in neurology or physical medicine & rehabilitation can properly prepare a physician to specialize in EDX medicine. For a detailed discussion of educational recommendations for physicians and the role of nonphysician providers in EDX testing, please refer to AANEM's positions statement “Who is Qualified to Practice EDX Medicine.”

A nonphysican provider’s ability to conduct EDX studies varies depending on state law, state regulations, various professional board decisions and policies, and individual private and public payer policies. For example, the only nonphysician providers permitted to perform and bill Medicare for needle EMG studies are physical therapists who practice in states that permit them to perform EDX testing and who have the American Physical Therapy Association’s (APTA) Clinical Electrophysiology Specialist Certification. That has been the rule for over 20 years and is codified in both federal regulation (42 CFR 410.32(b)(2)(iv)) and in Medicare’s various Local Coverage Determinations (LCDs).  There are some states that have expressly authorized chiropractors to perform needle EMG and some states that prohibit it; however, the majority of states have not expressly addressed the issue. Few, if any, states address the legality of other nonphysician medical providers’ performance of needle EMG studies. Oftentimes, it comes down to individual payers’ medical coverage policies as to whom is permitted to perform and bill each payer for EDX testing.

Video: Who Can Legally Perform EDX?

Because these laws, regulations, and other policies often change, AANEM recommends always checking with appropriate state authorities and/or licensed health-law attorney in your area on scope of practice rules in your provider community. You should also consult the applicable payer’s medical coverage policy.

If you suspect a provider has committed fraud or abuse, please see AANEM’s resources on EDX Fraud and Abuse  for next steps or contact AANEM’s policy department: You can contact the individual state's regulatory licensing board if you have concerns about the quality of the care provided.