Scope of Practice

Scope of Practice

U.S. State Dry Needling Scope of Practice Decisions

Resource: Federation of State Boards

The American Physical Therapy Association states that Dry Needling is within the scope of practice for a Physical Therapist. Several other health professions cite that dry needling is within their specific scope of practice as well. There are however, specific U.S. state rules, regulations and guidelines that do not permit the practice of dry needling. It is your responsibility to know, understand and practice within the specific rules, regulations and guidelines of your state, jurisdiction and professional license.
The Integrative Dry Needling Institute LLC is solely an educational resource to provide the knowledge and technical skills necessary to deliver safe and effective dry needling treatment. The Integrative Dry Needling Institute LLC does not make policy, claims, or interpretation on professional licensure or scope of practice. The Integrative Dry Needling Institute LLC encourages all participants to contact their licensing board for official positions and rulings related to the practice of dry needling.
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ALLOWED

Alabama

October 23 2007: Board Minutes: Acupuncture & Dry Needling does fall within the scope of practice for physical therapy.
ALLOWED

Alaska

April 24 2012: Letter regarding performance of dry needling. Paraphrase: The board will not address specific treatment approaches by licensure. However; expect the professionalism of the clinician to determine if they are qualified to provide the type of treatment in question or whether referral is more appropriate. The PT will be held accountable for demonstrating this competence if there is ever a complaint.
ALLOWED

Arizona

On April 25th, 2014 the Arizona physical therapy statute was ammended to include dry needling within the physical therapy scope of practice.
ALLOWED

Arkansas

The Arkansas Board of Physical Therapists has determined that Dry Needling is within the Scope Of Practice for physical therapists.
PROHIBITED

California

NO OPINION

Connecticut

The Connecticut Board of Examiners has not ruled for or against physical therapists performing dry needling.
ALLOWED

Delaware

July 1st. 2014: Delaware passed a bill that redefines and expands the ‘practice of physical therapy’ and ‘athletic training’ to include the use of dry needling treatment. Read the bill
ALLOWED

District of Columbia

PROHIBITED

Florida

Florida physical therapy practice act contains language which specifically excludes penetrating the skin in the performance of acupuncture: ‘Practice of physical therapy’ means the performance of physical therapy assessments and the treatment of any disability; injury; disease; or other health condition of human beings; or the prevention of such disability; injury; disease; or other condition of health and rehabilitation as related thereto by the use of the physical; chemical; and other properties of air; electricity; exercise; massage; the performance of acupuncture only upon compliance with the criteria set forth by the Board of Medicine; when no penetration of the skin occurs; The board has not yet taken up the issue of whether or not dry needling is acupuncture. For now; this statute prohibits dry needling in Florida.
ALLOWED

Georgia

2011 Dry needling added to GA PT practice act; only state to have in statute
PROHIBITED

Hawaii

Physical therapists; by statute; are not allowed to puncture the skin of a patient for any purpose
ALLOWED

Idaho

The passing of House Bill 505 enacted dry needling in the physical therapy practice act. The board is still in the process of determining the rules and regulations and they are scheduled to be released in early 2019. Read the Idaho Practice act.
ALLOWED

Illinois

Effective 8-25-17  Dry needling is in the scope of a Physical Therapist’s practice, however, they need meet the legal requirements. Read the Illinois practice act
NO OPINION

Indiana

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
ALLOWED

Iowa

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).
ALLOWED

Kansas

Dry needling was added to the Kansas statute on May 13, 2016 after Governor Brownback signed the bill.  Click here to read guidelines.
ALLOWED

Kentucky

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. Click here to read guidelines.
ALLOWED

Louisiana

ALLOWED

Maryland

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.
NO OPINION

Massachusetts

The Massachusetts Board of Allied Health Professionals has not formally ruled on dry needling by physical therapists.
NO OPINION

Michigan

The Michigan Physical Therapy board has not ruled for or against physical therapists performing dry needling.
NO OPINION

Minnesota

The Minnesota Physical Therapy licensure board is silent on dry needling. The board is prohibited from making position statements.
ALLOWED

Mississippi

NO OPINION

Missouri

The Missouri Board of Registration for the Healing Arts (Advisory Commission for Physical Therapists) has not formally ruled on the performance of dry needling by Missouri physical therapists.
ALLOWED

Nevada

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.
ALLOWED

New Hampshire

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

New Jersey

On February 9th, 2017 the State of New Jersey- Office of the Attorney General made the ruling that dry needling is not in the scope of practice of a Physical Therapist in the State of New Jersey. Read the Attorney General’s Ruling
ALLOWED

New Mexico

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.
PROHIBITED

New York

Affirmed in 2007 NY State Board issued an opinion in early 1990s that it was not an entry level skill and therefore could not be done.
ALLOWED

North Carolina

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. Read the RRC’s statement
NO OPINION

Oklahoma

Affirmed in 2007 NY State Board issued an opinion in early 1990s that it was not an entry level skill and therefore could not be done.
PROHIBITED

Oregon

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.
NO OPINION

Pennsylvania

Physical therapy board was advised by legal counsel that dry needling is not within the scope of practice of a physical therapist. There was opposition to the ruling by the President of the Pennsylvania Physical Therapy Association. Whether dry needling is within the scope of PT practice in Pennsylvania is currently undetermined.
ALLOWED

Rhode Island

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.
ALLOWED

South Carolina

In an email written in October 2004 in response to a licensed practitioners question regarding scope of practice and dry needling; the Chairperson affirmed that dry needling appears to fall within the SOP of a licensed PT in SC if they are fully trained in its use and comply with all legal and ethical requirements for professional practice in physical therapy.
ALLOWED

South Dakota

20:66:04:02. Dry needling course of study. The board may approve a course of study in dry needling that meets the following criteria:(1) The course of study shall include:(a) Surface anatomy as it relates to underlying tissues, organs, and other structures, including variations in form, proportion, and anatomical landmarks; (b) Both emergency preparedness and response procedures related to secondary physiological effects or complications with dry needling; (c) Both emergency preparedness and response procedures related to secondary emotional effects or complications associated with dry needling;(d) Standards for dry needle handling;(e) Factors influencing safety and injury prevention;(f) Personal protection procedures and techniques as related to dry needling;(g) Theoretical basis for dry needling;(h) Theoretical basis for combining dry needling with other interventions;(i) Secondary effects or complications associated with dry needling on other systems;(j) Theoretical basis of pain sciences, including anatomy, physiology, pathophysiology, and relation to body structures and function;(k) Indications, contraindications, and precautions related to dry needling;(l) Palpation techniques as related to dry needling;(m) Needle insertion techniques;(n) Needle manipulation techniques;(o) Physiological responses to dry needling; and(p) Solid filament needles;(2) The majority of the course of study shall be in-person. Courses held entirely online or by other distance learning will not satisfy this requirement; and (3) The physical therapist may only perform dry needling on the parts of the body included in the course of study. Source: 45 SDR 9, effective August 1, 2018. General Authority: SDCL 36-10-52.Law Implemented: SDCL 36-10-52.
ALLOWED

Texas

In May of 2016, Texas Attorney General Mr. Ken Paxton issued a ruling stating that “A court would likely conclude that the Board of Physical Therapy Examiners has authority to determine that trigger point dry needling is within the scope of practice of physical therapy”. Read the Attorney Generals opinion
ALLOWED

Utah

On April 1: Utah Governor Gary R. Herbert signed into law HB 367. The legislation amends the Utah physical therapy statute to specifically add dry needling to the physical therapist scope of practice. Read the full scope of practice amendments. Requirements
ALLOWED

Vermont

On June 22, 2015, the Office of Regulation replied pointing out that “under the existing law, the Vermont Office of Professional Regulation believes that physical therapists reasonably may practice TDN if appropriately trained and experienced, and if the therapy is reasonably indicated for the relief of an impairment of physical movement.”
PROHIBITED

Washington

 No. The statute that defines the practice of physical therapy allows a variety of interventions, but we conclude that the best reading of the statute excludes dry needling from the practice of physical therapy. Our conclusion is based solely on the law as currently written; it is not our role to weigh the policy benefits and drawbacks of authorizing physical therapists to engage in dry needling. The legislature, of course, could also expand the scope of physical therapy by amending the relevant statutes. Here is a link to the full AG’s opinion.
ALLOWED

West Virginia

July 18 2012: Opinion of the West Virginia Board of Physical Therapy Regarding Dry Needling Therapy: In summary; the Board is of the opinion that dry needling is within the scope of the practice of ‘physical therapy’ as defined by West Virginia Code.
ALLOWED

Wisconsin

July 2009 Board Minutes: Discussion of Dry Needling – Statute 448.50 (6) allows for ‘therapeutic intervention’ within the scope of physical therapy. Larry Nosse discussed the use of dry needling as a therapeutic technique. This process uses sterile techniques; the surface skin is cleaned; it does not draw blood and the physical therapists are trained in blood-body precautions. Mark Shropshire noted that the American Academy of Orthopedic and Manual Physical Therapists has made a position statement that dry needling is within the scope of practice of physical therapy. California; Nevada; Tennessee; and Florida do not allow this technique within the scope of practice within physical therapy because these states have language noting that PTs cannot puncture the skin. MOTION: Otto Cordero moved; seconded by Jane Stroede that the board considers trigger point dry needling as within the scope of practice of physical therapy provided that the licensed physical therapist is properly educated and trained. Motion carried unanimously.
ALLOWED

Wyoming

In a letter dated Aug 18 2009: the Wyoming Board of Physical Therapy affirmed that nothing in the current practice act would preclude PTs performing dry needling with proper credentials.