(vi) Occupational Safety and Health Administration’s Bloodborne Pathogen Protocol.
(4) Any physical therapist who obtained the requisite twenty-four (24) hours of instruction as described in paragraph (2)(b) in another state or country must provide the same documentation to the Board, as described in paragraph (2)(b), that is required of a course provider. The Board or its consultant must approve the practitioner’s dry needling coursework before the therapist can practice dry needling in this state.
(5) Dry needling may only be performed by a licensed physical therapist and may not be delegated to a physical therapist assistant or support personnel.
(6) A physical therapist practicing dry needling must supply written documentation, upon request by the Board, that substantiates appropriate training as required by this rule.
(7) All physical therapy patients receiving dry needling for the first time shall be provided written documentation from the patient’s physical therapist that includes a definition and description of the practice of dry needling, a description of the education and training taken by the physical therapist which qualifies the therapist to practice dry needling, and a description of any potential side effects of dry needling, and the patient must give written informed consent after acknowledging the risks before dry needling may begin.
Texas – Allowed :Based on the broad definitions of physical therapy established by the Legislature and the Board, the Board has concluded that “dry needling is within the scope of practice of a Texas physical therapist. TX allows PT to take DN Courses and currently they do not have any specific credential hours-requirements, but they said that it is the responsibility of the Licensee to make sure that he/she is competent enough to incorporate DN in their practice and use it safely. They can use the credentials and practice it. But they should be competent enough and have the complete knowledge and safety rules of it.
For TX Licensed PTA :The Texas PT Practice Act/rules do not prohibit a PTA from performing dry needling. The supervising PT holds the primary responsible for all physical therapy care rendered under his/her supervision, and is responsible for assuring that a PTA has the competencies required to perform any treatment or modality, including dry needling. Consideration should be given to the PTA’s level of skill/training and experience/advanced competency, the practice setting in which the procedure is performed, the type of monitoring that might be needed, and the acuity and complexity of the patient’s condition. It would be a violation of the PT Practice Act/Rules for a PT to delegate a technique or procedure to a PTA who is not competent to perform it, and it would be a violation of the PT Practice Act/Rules for a PTA to perform or attempt to perform techniques or procedures for which they are not competent. It is recommended that you review the rules and regulations of payer sources, i.e. Medicare/Medicaid or private insurance, to determine if dry needling is reimbursable if performed by a PTA as they can differ from the licensure rules/regs.
For TX Licensed OTs :According to §362.1(32)(C)(xiii) of the OT Rules, occupational therapy interventions and procedures that promote or enhance safety and performance in activities of daily living (ADL), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation include the application of physical agent modalities, and use of a range of specific therapeutic procedures (such as wound care management; techniques to enhance sensory, perceptual, and cognitive processing; manual therapy techniques) to enhance performance skills. The Texas Board of Occupational Therapy Examiners does not dictate the specific modalities, techniques, or procedures that may be incorporated into the occupational therapy plan of care. However, at all times, it is the responsibility of the occupational therapy practitioners (OTs and OTAs) to demonstrate competency in all modalities, techniques, and procedures used for treatment. The occupational therapy practitioners must know how to perform and demonstrate proficiency in, as noted, any modalities, techniques, or procedures performed; however, please note that the Board does not specify certifications they must hold for specific modalities, etc. The occupational therapy practitioners are responsible for all of the modalities, techniques, or procedures that are used and the use of such must comply with the OT Rules and OT Practice Act. To access the full OT Rules and OT Practice Act, please follow the link http://www.ptot.texas.gov/page/ot-acts-and-rules
Utah – Allowed :On April 1: Utah Governor Gary R. Herbert signed into law HB 367. The legislation amends the Utah physical therapy statute to specifically add dry needling to the physical therapist scope of practice.
Read the full scope of practice amendments.
Vermont – Allowed :On June 22, 2015, the Office of Regulation replied pointing out that “under the existing law, the Vermont Office of Professional Regulation believes that physical therapists reasonably may practice TDN if appropriately trained and experienced, and if the therapy is reasonably indicated for the relief of an impairment of physical movement.”
Virginia – Allowed : July 18 2012: Opinion of the West Virginia Board of Physical Therapy Regarding Dry Needling Therapy: In summary; the Board is of the opinion that dry needling is within the scope of the practice of ‘physical therapy’ as defined by West Virginia Code.
Board of Physical Therapy : Guidance on Dry Needling in the Practice of Physical Therapy
Upon recommendation from the Task Force on Dry Needling, the Board voted that dry needling is within the scope of practice of physical therapy but should only be practiced under the following conditions:
Dry needling is a technique used in physical therapy practice to treat trigger points in muscles. You should understand that this dry needling technique should not be confused with a complete acupuncture treatment performed by a licensed acupuncturist. A complete acupuncture treatment might yield a holistic benefit not available through a limited dry needling treatment
Guidance Document 112-9
Board of Physical Therapy Guidance on Dry Needling in the Practice of Physical Therapy
Upon recommendation from the Task Force on Dry Needling, the board voted that dry needling is within the scope of practice of physical therapy but should only be practiced under the following conditions:
Dry needling is not an entry level skill but an advanced procedure that requires additional training.
A physical therapist using dry needling must complete at least 54 hours of post professional training including providing evidence of meeting expected competencies that include demonstration of cognitive and psychomotor knowledge and skills.
The licensed physical therapist bears the burden of proof of sufficient education and training to ensure competence with the treatment or intervention.
Dry needling is an invasive procedure and requires referral and direction, in accordance with § 54.1-3482 of the Code of Virginia. Referral should be in writing and specific for dry needling; if the initial referral is received orally, it must be followed up with a written referral.
If dry needling is performed, a separate procedure note for each treatment is required, and notes must indicate how the patient tolerated the technique as well as the outcome after the procedure.
A patient consent form should be utilized and should clearly state that the patient is not receiving acupuncture. The consent form should include the risks and benefits of the technique, and the patient should receive a copy of the consent form. The consent form should contain the following explanation:
Dry needling is a technique used in physical therapy practice to treat trigger points in muscles. You should understand that this dry needling technique should not be confused with a complete acupuncture treatment performed by a licensed acupuncturist. A complete acupuncture treatment might yield a holistic benefit not available through a limited dry needling treatment.
Washington – Not Allowed:
The statute that defines the practice of physical therapy allows a variety of interventions, but we conclude that the best reading of the statute excludes dry needling from the practice of physical therapy. Our conclusion is based solely on the law as currently written; it is not our role to weigh the policy benefits and drawbacks of authorizing physical therapists to engage in dry needling. The legislature, of course, could also expand the scope of physical therapy by amending the relevant statutes. Here is a link to the full
On April 15, 2016, the Attorney General of Washington State concluded that “The definition of the practice of physical therapy indicates that the legislature did not intend to include dry needling within the scope of practice. We have been informed of many reasons for including dry needling in the practice of physical therapy and arguments to the contrary, but our role is not to resolve such public policy disputes. We conclude only that RCW 18.74, as currently written and implemented, does not encompass dry needling in the practice of physical therapy.”
West Virginia – Allowed :July 18 2012: Opinion of the West Virginia Board of Physical Therapy Regarding Dry Needling Therapy: In summary; the Board is of the opinion that dry needling is within the scope of the practice of ‘physical therapy’ as defined by West Virginia Code.
Wisconsin – Allowed :July 2009 Board Minutes: Discussion of Dry Needling – Statute 448.50 (6) allows for ‘therapeutic intervention’ within the scope of physical therapy. Larry Nosse discussed the use of dry needling as a therapeutic technique. This process uses sterile techniques; the surface skin is cleaned; it does not draw blood and the physical therapists are trained in blood-body precautions. Mark Shropshire noted that the American Academy of Orthopedic and Manual Physical Therapists has made a position statement that dry needling is within the scope of practice of physical therapy. California; Nevada; Tennessee; and Florida do not allow this technique within the scope of practice within physical therapy because these states have language noting that PTs cannot puncture the skin. MOTION: Otto Cordero moved; seconded by Jane Stroede that the board considers trigger point dry needling as within the scope of practice of physical therapy provided that the licensed physical therapist is properly educated and trained. Motion carried unanimously.
Wyoming – Allowed :In a letter dated Aug 18 2009: the Wyoming Board of Physical Therapy affirmed that nothing in the current practice act would preclude PTs performing dry needling with proper credentials. Only PTs allowed.