MedicaidCoverageMedium impact
Physical Therapist Coverage for Nerve Conduction Study (NCS)
Arkansas Medicaid·AR · Physical Therapy, Occupational Therapy, Speech Therapy·Provider Notice
Effective date
May 1, 2026
We identified it
May 7, 2026
Summary
Effective May 1, 2026, Arkansas Medicaid now covers Nerve Conduction Studies (NCS) performed by Board-Certified Physical Therapists in Clinical Electrophysiology. Physical Therapists can perform the technical component and provide professional interpretation, but cannot make medical diagnoses. All NCS procedures require prior authorization and must be physician-ordered.
Action Required
By May 1, 2026: Billing team must implement the following: (1) Update billing software to recognize CPT codes 95885, 95886, 95887, 95908-95913 as payable to Physical Therapists with provider type THER; (2) Configure system to require prior authorization (PA=Y) for all nine codes; (3) Establish workflow to verify that Physical Therapist performing NCS is Board-Certified Specialist in Clinical Electrophysiology via American Board of Physical Therapy Specialties website before claim submission; (4) Train front desk and clinical staff that NCS orders must originate from a Physician and that Physical Therapists cannot provide medical diagnoses based on results; (5) Update encounter forms and provider documentation templates to capture physician order requirement and certification status; (6) Ensure all prior authorization requests are submitted to Arkansas Foundation for Medical Care via phone (1-800-426-2234), fax (479-649-0799), or web portal (https://reviewpoint.afmc.org/s/login/). Claims submitted without prior authorization or from non-Board-Certified Physical Therapists will be denied.