Print Page   |   Contact Us   |   Your Cart   |   Sign In
Community Search
News & Press: Reimbursement

New Dry Needling Codes

Tuesday, March 3, 2020   (0 Comments)
Posted by: Matthew Nicholas
Share |

New Dry Needling Codes

Two new codes are now used when a PT delivers dry needling. The code terminology for the procedure is "needle insertion without injection." They are:

  • 20560 — Needle insertion(s) without injection(s); 1 or 2 muscle(s)
  • 20561 — Needle insertion(s) without injection(s); 3 or more muscle(s)

CMS has assigned these codes the status of "non-covered" services under Medicare. This means you will be able to bill a Medicare beneficiary directly for the services. Follow these procedures for submitting a claim to Medicare:

  • Provide a voluntary Advanced Beneficiary Notice to the patient
  • Include the appropriate code (20560 or 20561) on the claim
  • Append the GX modifier to indicate that you and the patient know the service is non-covered

For state Medicaid and commercial payers, check the individual policies to determine which payers cover the procedure when billed by PTs, and whether those payers will use the new codes or have designated an alternative code for billing dry needling. Also, see the accompanying map identifying which states by law permit dry needling, which prohibit it, and which are silent on it. Because Medicare doesn't cover dry needling codes, CSM has not designated them as either "sometimes therapy" or "always therapy." "Always therapy" services must be furnished under the plan of care of a PT, occupational therapist (OT), or speech-language pathologist (SLP), regardless of who provides them. The codes always are accompanied by the appropriate GP (for PTs), GO (for OTs), or GN (for SLPs) modifier.

03/03/20


more Calendar

9/29/2020
Let's Be Heart Smart and Figure out CHF!

9/30/2020
IPTA Board of Directors Meeting (ZOOM)

Career Center

Proud Partners of the IPTA

  • Athletico
  • ATI
  • DuPage Medical Group
  • Entropy
  • FYZICAL
  • IMPACT
  • PHYSIO PARTNERS
  • PTS Inc
  • SPORTS AND ORTHO
  • NORTHERN REHAB
  • Catalyst
  • Spotter
  • MAPS
  • HomeCEU
Association Management Software Powered by YourMembership  ::  Legal