1 would like to clear up your con- fusion. The MODALITIES can be performed by the CA or the physician. Some states, such as Tennessee, require that the C A be licensed first before he or she can perform these MODALITIES or PROCEDURES. The confusion that you are experiencing is because I was strictly talking about the PROCEDURES and mentioning the fact that the doctors need to pay attention to the definitions of each code so that they can clearly understand who can perform each PROCEDURE code and who cannot. I hope this helps. Dwighl Whynot, D. C.