Trigger Point Injections (TPI)

Covered only for diagnosis/treatment of myofascial pain from identifiable trigger points (single diagnostic TPI allowed); excludes dry needling, biological injectates, routine periodic TPI for chronic non‑malignant pain, TPI for headache/neck/back or other listed conditions in the absence of true trigger points, use of ultrasound/fluoroscopy/MRI guidance, injections into multiple anatomical regions or multiple other blocks in the same session, with reimbursement limited to ≤3 TPI sessions per rolling 12 months. Key requirements: initial TPI requires focal skeletal muscle pain with clinical trigger point findings (≥2 findings such as taut band/hyperirritable spot/local twitch/referred pain), a focal hypersensitive nodule, and failure of conservative therapy or movement limitation or diagnostic intent; subsequent TPIs require documented prior ≥50% pain relief lasting ≥6 weeks measured on the same pain scale, objective ≥50% functional improvement on a validated scale, baseline/post‑injection pain and function documentation, participation in a conservative/rehab program, and appropriate provider credentials.