Insurance companies often have strict guidelines for covering dry needling. For instance, some payers consider it medically necessary only in specific clinical scenarios, such as myofascial trigger point-related pain or temporomandibular joint disorders, and typically limit coverage to up to three sessions [7].
The price for dry needling sessions varies according to practitioner. Some charge about $40 to $60 per session, others as low as $15 per session. Usually, people receiving dry needling attend between 3 to 6 sessions. More sessions may be necessary, depending on the pain and responses to the therapy.
Dry needling of trigger points for the treatment of myofascial pain is considered investigational for all applications. BCBSNC does not provide coverage for investigational services or procedures.
Common Dry Needling CPT Codes
The Centers for Medicare & Medicaid Services (CMS) approved only 2 CPT codes for dry needling: 20560 & 20561. So thankfully, these are easy to remember. CPT code 20560 covers needle insertion without injection in 1 or 2 muscles.
Dry needling treats muscle tissue with the goal of reducing pain, inactivating trigger points and improving movement. Typically, it's used as part of a broader physical therapy approach that includes other physical therapy treatments.
It May Cause Muscle Soreness
Muscle soreness is a common side effect of dry needling. Dry needling can even make your body feel worse than before the treatment. It's important to know that your body might need to learn to respond better to treatment before you start to feel the benefits.
However, dry needling is still not covered by many US insurance companies, including CMS or Medicare, who readily claim that dry needling would be investigational or experimental despite the overwhelming evidence to the contrary!
Insurance companies often have strict guidelines for covering dry needling. For instance, some payers consider it medically necessary only in specific clinical scenarios, such as myofascial trigger point-related pain or temporomandibular joint disorders, and typically limit coverage to up to three sessions [7].
Dry needling is illegal in some states due to concerns about safety, training, and scope of practice. Regulatory bodies in these states argue that without standardized training, there is a higher risk of complications, such as nerve damage or infections.
Dry needling is not for those with unmanaged blood-clotting or immune-system disorders. Plus, the American Physical Therapy Association does not recommend dry needling for children younger than 12. Always check with your medical provider or physical therapist if you have concerns.
Pre-authorization: Your insurance provider may require pre-authorization before you start physical therapy, which involves obtaining approval for the services to ensure they are covered. Referral: Some insurance plans may require a referral from your primary care physician before covering physical therapy services.
The cost of the treatment differs from one place to the other. However, a single session of dry needling may cost anywhere between Rs. 500 to Rs. 1,000.
BCBSVT does not consider dry needling to be an injection and should not be billed with CPT® code 20552 (Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) or CPT® 20553 (single or multiple trigger point(s), 3 or more muscles.
What Does Dry Needling Feel Like? The act of dry needling typically doesn't hurt the patient. The therapist uses a guide tube to insert a sterile, thin filiform needle into the target muscle group.
$75,000 - $85,000. Our patient care approach focuses on manual therapy techniques, including dry needling, to help individuals reach their highest potential.
There are several alternative treatments that may be more effective than dry needling, depending on your condition and preferences. Some of these alternatives include acupuncture, physical therapy, massage therapy, and chiropractic care.
Treatments can run anywhere from $40 to $100+ per session. Still, when you compare these costs to copays for pain medication and more invasive procedures, dry needling may be more cost-effective overall. Contact your insurance provider to find out if dry needling is covered, and what you need to submit a claim.
No prerequisites are needed for this three-day 27-hour dry needling course; however, registrants must be a licensed PT, PTA, ATC, DC, MD, DO, DDS, NP, PA, OT, or acupuncturist in their respective state or country. DPT, DC, or MD students in their final year are also eligible to take DN-1 and DN-2.
Each dry needling CPT code type is differentiated by the number of muscles treated in the session. The two TPDN CPT codes are: Code 20560: Needle insertion(s) without injection; 1 or 2 muscle(s). Code 20561: Needle insertion(s) without injection; 3 or more muscle(s).
Dry needling may not be appropriate for everyone, particularly individuals with certain medical conditions or risk factors. For example, individuals with bleeding disorders, compromised immune systems, or a fear of needles may not be suitable candidates for dry needling.
Dry needling is a safe technique for treating many musculoskeletal conditions, including shoulder pain, rotator cuff pain, biceps tendinitis, iliotibial band syndrome, Achilles tendinitis, low back pain, tennis elbow, whiplash or neck pain, headaches, muscle strains, hip pain and temporomandibular pain, also called TMJ ...
The minimal requirements for documenting dry needling are in addition to and not in place of normal physical therapy notes, and include at least the following information: i. The anatomical region treated; ii. The manner in which the patient tolerated the treatment; and iii. The clinical outcome of the treatment.