Billing and Coding: Trigger Point Injections (TPI)

Trigger point injections (CPT 20552 and 20553) are covered when medically necessary to treat documented myofascial trigger points, with required documentation of location, muscles injected, injectant name/units, and immediate pre/post-percent pain relief. Coverage is limited to no more than 3 injection sessions in a rolling 12 months; CPT 20552 is for 1–2 muscles and CPT 20553 for 3+ muscles, medications must be billed on the same claim, biological/non‑FDA injectants may lead to claim denial, and modifiers/anesthesia codes specified in the policy are prohibited.

"Trigger point injections (CPT 20552 or 20553) are covered when medically necessary to treat documented myofascial trigger points causing pain, with procedural documentation supporting medical neces..."

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