Medicare Will Only Pay for Nerve Tests at Accredited Facilities: What the New Quality Rules Mean for Your Doctor’s Office

This bill, officially the Electrodiagnostic Medicine Patient Protection and Fraud Elimination Act of 2025, sets up a major overhaul for how Medicare Part B pays for two specific diagnostic tests: nerve conduction studies and needle electromyography (EMG) tests. The core change is simple but huge: three to four years after this bill passes, Medicare will stop paying for these services unless they are performed at a “qualified facility.” The only exception is for tests done during surgery.

The Accreditation Barrier: Raising the Bar on Quality

The goal here is to crack down on fraud and ensure patients get reliable, high-quality diagnoses. To be a "qualified facility," a provider must get accredited by an organization approved by the Department of Health and Human Services (HHS). This isn't just about hanging a plaque on the wall, though. The bill mandates strict requirements for accreditation, including having a dedicated quality assurance program, specific high-tech equipment capable of measuring amplitude and latency, and strict rules about who can perform and interpret the tests.

For example, if you need a needle EMG test, the person performing it must have completed at least three months of relevant training during an accredited residency or fellowship. Crucially, the bill demands immediate, on-site interpretation of results. For nerve conduction studies, the person who did the study or supervised it must interpret it right then and there. This provision directly targets providers who might rely on cheaper, remote interpretation services, forcing providers to have senior, qualified personnel present for every test.

The Real-World Friction: Access vs. Quality

While better quality control sounds great—who doesn't want an accurate diagnosis?—this new system creates potential headaches for regular people and smaller providers. For Medicare beneficiaries, especially those in rural areas, this could mean losing access to their current facility if that provider can’t afford the time or money to meet the new accreditation standards. Independent diagnostic testing facilities (IDTFs) and smaller clinics that can't shell out for new equipment or ensure a highly trained specialist is always on-site could be forced out of the Medicare game.

Think of it this way: if your local clinic currently sends its test results to a specialist across the state for interpretation, they’ll have to stop that practice entirely. They must now hire or contract with a qualified expert who is physically present. If they can’t, Medicare won't cover your test there anymore. This is a very real access concern, even if the intent is to weed out low-quality or fraudulent testing.

The Bureaucratic Build-Out

The bill gives HHS two years to set up the entire accreditation system, which includes approving the organizations that will do the actual accrediting. To help guide this process, the bill mandates the creation of a new group: the National Electrodiagnostic Services Advisory Committee. This committee, made up of doctors, physical therapists, and patient representatives, will advise HHS on setting standards, with a focus on reducing unnecessary treatments, cutting down on retesting, and fighting fraud. While this committee adds necessary expertise, the timeline for getting this complex system up and running—and getting thousands of facilities accredited—is aggressive, which could lead to initial chaos or restricted service availability when the payment restrictions kick in three to four years from now.