Dry Needling, also known as Trigger Point Needling, has been the topic of confusion for a while now when it comes to coding. In this article, we will break down what was proposed for the year 2020, and what will actually take place (hint: it’s not what many experts were expecting).
The American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA) have combined forces since 2009 to obtain appropriate codes to describe this service. Things were seemingly going well and The Centers for Medicare & Medicaid Services (CMS) proposed to assign an active status to Common Procedural Technology (CPT) codes 20560 (1-2 muscles) and 20561 (3 or more muscles), which would go into effect on January 1st, 2020. Please see CMS Proposed Rule Revisions: Dry Needling.
As with most things in life, there’s good news and there’s bad news. The good news is that CMS did approve the two new codes for dry needling, the above-mentioned 20560 and 20561. Unfortunately, that’s about all the good news there is for dry needlers. Instead of finalizing these codes as "always therapy" or "sometimes therapy" CMS assigned a non-covered status to CPT codes 20560 and 20561. As CMS puts it, "dry needling services are non-covered unless otherwise specified through a national coverage determination (NCD)." To read that section of the NCD Manual, please click HERE.
To put it another way, the good news is that therapists finally have some dedicated dry needling codes. The bad news is that Medicare will not pay for them.
While therapists won't be happy about the new rulings, it doesn't mean the new code assignments are permanent. CMS may revisit this sometime in the future. Although when that happens is anyone's guess.
Please be careful not to confuse the new codes (20560 & 20561) with existing CPT codes for trigger point injection (20552-20553) or acupuncture (97810-97814). The new codes describe needle insertion into trigger points, but unlike the trigger point codes, no medication is administered through the needles.
Strata PT continues to monitor all changes to the CPT codes that may affect physical therapists. We do the complicated work so you can focus on your practice. To request a demo with one of our friendly team members, please contact us today.