Wiki Physical Therapy & Dry Needling under CPT code 20560

[JLMurrell]

I work in Outpatient Rehabilitation, specifically Physical, Occupational, & Speech Therapy. Since we are based in WV the physical therapist with appropriate credentials can perform dry needling (CPT 20560 or 20561). However, we have had lots of conversations about what insurances will and will not pay for the codes. Does anyone have any information on which insurances will and will not cover CPT codes 20560 or 20561?

 

[amyjph]

If they are a member of the APTA check there. Physician Fee Schedule Coding Updates

Considering Providing Dry Needling Services?

Understand your professional, legal, and personal scopes of practice.

www.apta.org

Dry Needling State Laws

This map displays the states that specifically allow dry needling by PTs, states that prohibit the intervention by PTs, and states in which a clear opinion has not surfaced.

www.apta.org

Billing for Dry Needling | WebPT

Rehab therapists billing for dry needling must be mindful of these compliance and payer issues to avoid denials—or worse.

www.webpt.com

"The best way to know if a payer pays for TPDN or whether they consider it not medically necessary is to check their physical therapy medical policy; you might find it under outpatient rehabilitation services or part of their trigger point injection policy."

Example non-covered: https://files.providernews.anthem.com/3532/PDF-Rehab-PT-OT-ST-2024-04-14.pdf
• Dry needling is considered not medically necessary in all clinical scenarios.

 

[JLMurrell]

e best way to know if a payer pays for TPDN or wh

We have been checking every insurance website and plan, but so far we have not found any one that will cover dry needling. I just want to know if anyone has found a payer that is covering it. I am beginning to feel like a code was created, but no one is covering it .