BlueCross BlueShield of Tennessee Medical Policy Manual

Surface Electromyography (sEMG)


Surface electromyography (sEMG) is a non-invasive procedure involving the detection, recording and interpretation of the electric activity of groups of muscles at rest (i.e., static) and during activity (i.e., dynamic). The procedure is performed using a single or an array of electrodes placed on the skin surface over the muscles to be tested. Recording can also be made using a hand-held device, which is applied to the skin surface at different sites. Electrical activity is assessed by computer analysis of the frequency spectrum, amplitude, or root mean square of the electrical action potential. Surface electromyography is occasionally used as an aid to diagnose neuromuscular disorders, determine the need for surgery in individuals with low back pain, and assist in evaluating the prognosis of disorders involving muscle lesions. The technology has also been utilized to monitor the effects of rehabilitation programs and evaluate muscular function in occupational and sports programs.

Needle electromyography is an invasive procedure that records the electrical activity of individual muscles and is considered a more reliable technology.

Paraspinal sEMG, also referred to as paraspinal EMG scanning, has been explored as a technique to evaluate abnormal patterns of electrical activity in the paraspinal muscles in patients with back pain symptoms such as spasm, tenderness, limited ROM, or postural disorders. The technique is performed using electrodes placed on the skin surface, with recordings made at rest, in various positions, or after a series of exercises.

Note: This policy only applies to the application of surface electromyography to the skin and does not apply to electromyography studies of the anal or urethral sphincter or needle EMG.


See also:



There are no data on the impact of SEMG on patient management or health outcomes. The evidence is insufficient to determine the effects of the technology on health outcomes. Therefore, this technology remains investigational.


American Academy of Neurology (2009). Clinical utility of surface EMG: Report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology, (55) 2, 171-177.

American Association of Neuromuscular & Electrodiagnostic Medicine (2008, April) Evidence based review: use of surface electromyography in the diagnosis and study of neuromuscular disorders. Muscle and Nerve, (38) 4, 1219-1224.

American College of Occupational and Environmental Medicine. (2011). Low back disorders. Occupational medicine practice guidelines. Evaluation and management of common health problems and functional recovery in workers. 3rd ed., 333-796. Retrieved August 21, 2014 from the National Guideline Clearinghouse (NGC: 009327).

Bandpei, M., Rahmani, N., Majdoleslam, B., Abdollahi, I.,  Ali, S., and Ahmad, A. (2014) Reliability of surface electromyography in the assessment of paraspinal muscle fatigue: an updated systemic review. Journal of Manipulative and Physiological Therapeutics. Vo. 37, No. 7, 511-521. (Level 2 evidence)

BlueCross BlueShield Association. Medical Policy Reference Manual. (9:2015). Paraspinal surface electromyography (EMG) to evaluate and monitor back pain (2.01.35). Retrieved November 3, 2016 from BlueWeb. (18 articles and/or guidelines reviewed)

Cahaba Government Benefit Administrators, LLC. (2015, October) Local Coverage Determination (LCD): Medicine: Physical Therapy - Outpatient (L34310) Retrieved November 3, 2016 from:

Ciesielska, J., Lisinski, P., Bandosz, A., Huber, J., Kulczk, A., & Lipiec, J. (2015). Hip strategy alterations in patients with history of low disc herniation and non-specific low back pain measured by surface electromyography and balance platform. Acta of Bioengineering and Biomechanics, 17 (3), 103-108. Abstract retrieved January 13, 2016 from PubMed database.

Maranesi, E., Fioretti, S., Ghetti, G., Rabini, R., Burattini, L., Mercante, O., et al. (2015). The surface electromyographic evaluation of the Functional Reach in elderly subjects. Journal of Electromyography and Kinesiology. Epub ahead of print. Abstract retrieved January 13, 2016 from PubMed database.

U. S. Food and Drug Administration. (2004, January). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K031995. Retrieved September 28, 2009 from 

U. S. Food and Drug Administration. (2007, August). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K063447. Retrieved November 3, 2016 from:




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