CMM-202: Trigger Point Injections

Trigger point injections are covered only when a myofascial trigger point is identified on exam (referred pain, tenderness, muscle shortening or autonomic signs) and the injection uses a local anesthetic with or without steroid; injections using other substances (e.g., saline/glucose/biopuncture), dry needling, acupuncture/electro-acupuncture/acupoint injections, image‑guided injections over spinal hardware, same‑day treatments in the same region, or isolated repeat use are excluded. Key requirements: document the trigger point and substance injected, and for repeat injections show ≥50% pain relief with functional improvement for ≥6 weeks plus instruction/supervision in self‑management, with ≥2‑month intervals and no more than four sessions per body region per year (medical necessity determined case‑by‑case).

"Repeat trigger point injections are considered not medically necessary as an isolated treatment modality"