physical therapist or physical therapist assistant licensed under this Act may only perform dry needling after completion of requirements, as determined by the Department by rule, that meet or exceed the following:

(1) 50 hours of instructional courses that include, but are not limited to, studies in the musculoskeletal and neuromuscular system, the anatomical basis of pain mechanisms, chronic and referred pain, myofascial trigger point theory, and universal precautions;

2) completion of at least 30 hours of didactic course work specific to dry needling;

(3) successful completion of at least 54 practicum hours in dry needling course work;

(4) completion of at least 200 supervised patient treatment sessions; and (5) successful completion of a competency examination. Dry needling shall only be performed by a licensed physical therapist or licensed physical therapist assistant.

Indiana – Allowed

August 2012: Board meeting minutes – Claimed by some resources to have approved dry needling for PTs; minutes state that “Indiana does not take a position on needling. The current statute is open and does not specifically state whether or not it is appropriate.” Not prohibited; but not endorsed either. As an update to prior opinion in 2012 The IN APTA as of July 2013 has not declared a particular stance on dry needling but rather follows the National APTA White Paper on Dry Needling as within the scope of practice for PTs

Iowa – Allowed

On January 14, 2016, the Iowa Board of Physical & Occupational Therapy issued a Ruling on the Petition for Declaratory Order and concluded that dry needling is within the scope of physical therapy practice as defined in Iowa Code section 148A.1(1)(b).

On January 10, 2018, the Iowa Court of Appeals issued a decision upholding the declaratory order of the Iowa Board of Physical and Occupational Therapy that dry needling is within the scope of physical therapy. The Board issued its order in response to a petition filed in August of 2015 by the Iowa Association of Oriental Medicine and Acupuncture. The APTA and the Iowa Chapter petitioned to intervene and submitted a joint brief to the Board. The Board’s order, issued in January of 2016, declared that dry needling was a “rehabilitative procedure” within the definition of physical therapy in the practice act. The Acupuncture Association sought judicial review in the District Court. The Iowa Chapter intervened on the side of the Board. In October, 2016, the District Court affirmed the Board’s declaratory order.

The Acupuncture Association next filed an appeal, which the Iowa Supreme Court transferred to the Iowa Court of Appeals. The Iowa Chapter intervened in support of the Board and submitted a brief. The Court of Appeals held a hearing on December 12, 2017, at which the APTA’s General Counsel, Jack Bennett, argued on behalf of the Chapter. The opinion of the Court of Appeals noted that the standard of judicial review was highly deferential to the Board. The Court concluded:“The Board is generally allowed to apply its expertise in the area of physical therapy to determine what matters are within the scope of the practice. In granting deference to the Board’s expertise in the area of physical therapy, we conclude its determination that the practice of dry needling falls within the definition of physical therapy was not irrational, illogical, or wholly unjustifiable.”The decision by the Court of Appeals is not necessarily the end of the case, because the Acupuncture Association has seven days in which to ask the Court of Appeals for a rehearing, and it has twenty days in which to apply to the Iowa Supreme Court for further review of the case. The decision of the Court of Appeals is available here.

Kansas – Allowed

On May 13, 2016, Kansas Governor Sam Brownback signed legislation affecting the use of dry needling by physical therapists. The legislation clarifies that dry needling is within the scope of practice of physical therapy in Kansas. The new dry needling provisions in the physical therapy practice act will take effect July 1, 2016. Kansas is now working on developing rules and regulations for dry needling. On April 14, 2017, the Kansas Board of Healing Arts approved the Dry Needling Regulations for Physical Therapists in the state of Kansas.

Kentucky- Allowed

KRS 327.070(2)

The board is of the opinion dry needling is within the scope of the practice of physical therapy as defined in Kentucky law by the General Assembly at KRS 327.010(1). Dry needling is a treatment used to improve neuromuscular function. As such it falls within the definition of physical therapy as defined under KRS 327:010 (1): Physical therapy – means the use of selected knowledge and skills; invasive or noninvasive procedures with emphasis on the skeletal system; neuromuscular; and cardiopulmonary function; as it relates to physical therapy. There is nothing in KRS Chapter 327 to prohibit a licensed physical therapist from performing dry needling so long as the physical therapist is competent in performing this intervention.

While dry needling is within the scope of practice of physical therapy, a physical therapist must practice only those procedures that the physical therapist is competent to perform. The board can discipline a physical therapist for “engaging or permitting the performance of substandard patient care by himself or by persons working under their supervision due to a deliberate or negligent act or failure to act, regardless of whether actual injury to the patient is established.”

Louisiana -Allowed

In May 2011, the Louisiana Board of Physical Therapy issued standards of practice for the utilization of dry needling techniques, which formally established dry needling in the scope of practice of a physical therapist.

311. Treatment with Dry Needling

A. The purpose of this rule is to establish standards of practice, as authorized by R.S. 37:2405 A.(8), for the utilization of dry needling techniques, as defined in §123, in treating patients.

B. Dry needling is a physical therapy treatment which requires specialized physical therapy education and training for the utilization of such techniques. Prior to utilizing dry needling techniques in patient treatment, a PT shall successfully complete a board-approved course of study consisting of no fewer than 50 hours of face-to-face instruction in intramuscular dry needling treatment and safety. Online and other distance learning courses will not satisfy this requirement. Practicing dry needling without compliance with this requirement constitutes unprofessional conduct and subjects a licensee to appropriate discipline by the board.

C. In order to obtain board approval for courses of instruction in dry needling, sponsors must document that instructors utilized have had no less than two years experience utilizing such techniques. Instructors need not be physical therapists, but should be licensed or certified as a healthcare provider in the state of their residence.

D. Prior to performing the initial dry needling treatment on a patient the physical therapist shall educate the patient of the potential risks and benefits of dry needling and receive informed consent from the patient. Documentation of the education and consent shall be maintained in the patient treatment record.

E. Dry needling treatment shall be performed in a manner consistent with generally accepted standards of practice, including sterile needle procedures and the standards of the U.S. Centers for Disease Control and Prevention. Treatment notes shall document how the patient tolerated the technique and the outcome of treatments.

F. PT students who have met the requirements of paragraph B. above may practice dry needling under the continuous supervision of a PT who has successfully completed the dry needling training requirements.

La. Admin. Code tit. 46, § LIV-311

Promulgated by the Department of Health and Hospitals, Physical Therapy Board, LR 37:3049 (October 2011), Amended by the Department of Health, Physical Therapy Board, LR 442180 (12/1/2018), Amended by the Department of Health, Physical Therapy Board, LR 451206 (9/1/2019), Amended by LR 471137 (8/1/2021).AUTHORITY NOTE: Promulgated in accordance with R.S. 37:2405.A (8) and Act 535 of 2009.

Maine – Allowed

June 17, 2016: The Board voted in full agreement that “dry needling” is a recognized technique associated with the practice of physical therapy and is an appropriate technique when used during the course of a physical therapy treatment.

Maryland- Allowed

The Maryland board of Physical Therapy Examiners ruled that dry needling is in the scope of practice of a Physical Therapist as long as they meet the minimum education and training requirements. A full description of the requirements is listed here.

Massachusetts – Silent.

Michigan- Silent: The Michigan Physical Therapy board has not ruled for or against physical therapists performing dry needling.

MINNESOTA – Unclear : The Minnesota Physical Therapy licensure board is silent on dry needling. The board is prohibited from making position statements.

Mississippi (APTA statement here ) – Allowed

A.To be deemed competent to perform intramuscular manual therapy a physical therapist must meet the following requirements:

1. Documented successful completion of a intramuscular manual therapy course of study; online study is not considered appropriate training. a. A minimum of 50 hours of face-to-face IMS/dry needling course study; online study is not considered appropriate training. b. Three years of practice as a licensed physical therapist prior to using the intramuscular manual therapy technique.

2. The physical therapist must have board approved credentials for providing intramuscular manipulation which are on file with the board office prior to using the treatment technique. The provider of the required educational course does not need to be a physical therapist. A intramuscular manual therapy course of study must meet the educational and clinical prerequisites as defined in this rule,

C(1)(a)&(b) and demonstrate a minimum of two years of intramuscular manual therapy practice techniques.

A physical therapist performing intramuscular manual therapy in his/her practice must have written informed consent for each patient where this technique is used. The patient must sign and receive a copy of the informed consent form. The consent form must, at a minimum, clearly state the following information:

1. Risks and benefits of intramuscular manual therapy.

2. Physical therapist’s level of education and training in intramuscular manual therapy

3. The physical therapist will not stimulate any distal or auricular points during intramuscular manual therapy. When intramuscular manual therapy is performed, this ust be clearly documented in the procedure notes and must indicate how the patient tolerated the technique as well as the outcome after the procedure.

4.Intramuscular manual therapy shall not be delegated and must be directly performed by a qualified, licensed physical therapist. G. Intramuscular manual therapy must be performed in a manner consistent with generally accepted standards of practice, including but not limited to, aseptic techniques and standards of the center for communicable diseases.

Missouri – Silent

Montana – Allowed

24.177.413 DRY NEEDLING

(1) Dry needling is a skilled technique performed by a physical therapist using a mechanical device, filiform needles, to penetrate the skin and/or underlying tissues to affect change in body structures and functions for the evaluation and management of neuromusculoskeletal conditions, pain, movement impairments, and disability.

(2) Dry needling requires a physical therapy examination and diagnosis.

(3) Licensed physical therapists who perform dry needling must be able to demonstrate they have completed training in dry needling that must meet the American Physical Therapy Association (APTA) GUIDELINES: STANDARDS OF QUALITY FOR CONTINUING EDUCATION OFFERINGS BOD G11- 03-22-69 and/or the Federation of State Boards of Physical Therapists (FSBPT) STANDARDS FOR CONTINUING COMPETENCE ACTIVITIES.

(a) Dry needling courses must include, but not be limited to, training in indications, contraindications, potential risks, proper hygiene, proper use and disposal of needles, and appropriate selection of clients.

(b) Initial training in dry needling must include hands-on training, written, and practical examination as required by this rule.

(4) A licensed physical therapist must perform dry needling in a manner consistent with generally accepted standards of practice, including relevant standards of the Center for Disease Control and Prevention, and Occupational Safety and Health Administration blood borne pathogen standards as per 29 CFR 1910.1030 et.seq.

(5) Dry needling shall only be performed by a licensed physical therapist and may not be delegated.

(6) The physical therapist performing dry needling must be able to provide written documentation, upon request by the board, which substantiates appropriate training as required by this rule. Failure to provide written documentation may result in disciplinary action.

Nebraska – Allowed

On July 8, 2016, the Attorney General of Nebraska, Mr. Douglas Peterson, issued a ruling that “If dry needling is defined using the descriptions provided to this office by the Board of Physical Therapy and the APTA, it is our opinion that a reasonable legal argument can be made that dry needling is a “mechanical modality” or a “physical agent or modality” and, therefore, falls within the statutory definition of physical therapy.” In addition, it was opinioned that dry needling was not within the scope of practice for OTs and Athletic Trainers. A copy of the legal opinion is available

here.

A physical therapist who wished to perform tissue penetration for the purpose of dry needling must meet the following requirements:

1. Complete pre-service or in-service training. The pre-service or in-service training must include:

2. Pertinent anatomy and physiology;

3. Choice and operation of supplies and equipment;

4. Knowledge of technique including indications and contraindications;

5. Proper technique of tissue penetration;

6. Sterile methods, including understanding of hazards and complications; and

7. Post intervention care; and

8. Documentation of application of technique in an educational environment.

9. The training program shall require training to demonstrate cognitive and psychomotor skills. Also, the training program must be attended in person by the physical therapist.

10. Maintain documentation of successful completion of training.

Nevada – Allowed :

Dry needling is within the scope of practice of physical therapists as ruled by NV Board of PT on March 20 2012. As of April 19 2012; the PT board legal counsel is writing up the new board Policy on dry needling and once signed by Chairman Kathy Sidener; dry needling will be permissible by PTs in NV.

New Hampshire – Allowed : October 19 2011: Physical Therapy Board Minutes: PTs can do dry needling if they have been trained to do so.

New Jersey – Allowed : P.L. 2021, c.382 was signed by Governor Murphy on Jan 18th, 2022 which permits PTs to perform dry needling under certain circumstances

New Mexico – Allowed : March 2000

: In a letter dated March 21 2000; the PT board determined that the PT Act does not prohibit dry needling and that Section 61-12D-3: Paragraph I: Number 2 – describing the practice of physical therapy supports that decision.

New York : Not Allowed

North Carolina – Allowed :

On January 15th, 2015 the Rules Review Commission meeting restated the board’s opinion that dry needling is within the scope of practice of physical therapy. The Board also believes physical therapists can continue to perform dry needling so long as they possess the requisite education and training required by N.C.G.S. § 90-270.24(4), but there are no regulations to set the specific requirements for engaging in dry needling.

APTA new guidelines Read the RRC’s statement

On August 2, 2017, Louis A. Bledsoe, III, Special Superior Court Judge for Complex Business Cases of the North Carolina General Court of Justice, Superior Court Division, ruled that physical therapists may perform dry needling. A copy of the legal opinion is available

here

The Court’s ruling affirms a decision by the North Carolina Board of Physical Therapy Examiners that reached the following conclusions:

1. “The scope of physical therapy under North Carolina law includes dry needling.”

2. Dry needling is distinct from acupuncture.”

3. The Acupuncture Board “fails to recognize that health professions are allowed to have overlapping scope of practice.”

4. “North Carolina public policy favors patient choice in health care.”

NORTH DAKOTA– Allowed : Board meeting May 13 2013: The board voted to state that ‘Dry Needling’ is within the scope of practice for PT in North Dakota.

Ohio – Allowed : It is the position of the Physical Therapy Section that nothing in the Ohio Physical Therapy Practice Act prohibits a physical therapist from performing dry needling techniques. As with any specialized procedure, the physical therapist must have training and demonstrate competency in the modality. The manner in which the training is obtained and competency demonstrated are not addressed in the Practice Act. The PT Board recommends you contact the OPTA for approved coursework in dry needling at www.ohiopt.org .

Oklahoma : Silent.

Oregon – Not Allowed: On May 17, 2017, the Attorney General of Oregon issued a statement that dry needling is not within the scope of practice of a licensed Oregon Physical Therapist.

Pennsylvania – Silent: Physical therapy board was advised by legal counsel that dry needling is not within the scope of practice of a physical therapist

Rhode Island – Allowed : Feb 14 2012 PT board minutes: Board members revisited the matter of dry needling for intramuscular therapy. A board member questioned if it pertained to other professions; including Acupuncturist. The board administrator related guidance from attorney Tom Corrigan stating the use of a needle by one profession does not preclude a different profession from having a different use for a needle. Board members comment dry needling is within their scope of practice provided the licensed professional is comfortable trained and has appropriate background knowledge. For licensed physical therapists that are not qualified, there are educational seminars they may sign up for and gain the required background and training.