CMM-202: Trigger Point Injections

Covered only for clinically identified myofascial trigger point pain using a local anesthetic with or without steroid; injections for other pain types or with other injectates/techniques (e.g., acupuncture, dry needling, acupoint/biopuncture, electro‑acupuncture, image‑guided injections over spinal hardware) are excluded. Initial injections require documented physical‑exam findings (referred pain, tenderness, muscle shortening, or autonomic phenomena); repeats require ≥50% documented pain relief with functional improvement for ≥6 weeks, participation in conservative self‑care, ≥2‑month intervals between injections, a maximum of four sessions per body region per year, and full documentation of injectate, dates, technique, and single invasive modality per service date.

"This guideline criteria is only applicable for trigger point injections performed for myofascial trigger point pain."