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Blue Cross & Blue Shield of MississippiCommercial · Coverage · Medical Policy · Pain Management, PM&R (Physical Medicine & Rehab), OrthopedicsMedium impact

Trigger Point Injections

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Trigger point injection of abnormally sensitive areas in muscles, ligaments, joint capsules, tendons and related tissues may be considered medically necessary to relieve spasm and diminish myofascial pain. One reimbursement is made per site, per session, regardless of the number of trigger point injections, and separate billing for the injected drug is not allowed because it is included in the administration of the injection. Reimbursement is limited to ten sessions in a three-month period for tendon sheath, ligament, trigger point or ganglion cyst injections (CPT 20550), two injections per joint within thirty days for small and intermediate joints (CPT 20600 and 20605), and four services per site within thirty days for major joints or bursa (CPT 20610), and no coverage is allowed beyond these treatment limits.

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What to do

Action · 8 steps
01REQUIREMENTS: Report one reimbursement per site, per session, regardless of the number of trigger point injections.
02Do not bill separately for the drug injected, because it is included in the administration of the injection.
03Limit tendon sheath, ligament, trigger point or ganglion cyst injections (CPT 20550) to ten sessions in a three-month period.
04Limit arthrocentesis, aspiration and/or injection of small and intermediate joints (CPT 20600 and 20605) to two injections per joint within thirty days.
05Limit arthrocentesis, aspiration and/or injection of major joint or bursa (CPT 20610) to four services per site within a thirty-day period.
06Beyond the treatment limits specified, no coverage is allowed.
07BCBSMS makes no payment for services that are not documented to be medically necessary, and a provider's order or recommendation does not in itself make a service medically necessary.
08The listed codes are medically necessary only if the procedure is performed according to the policy section.

Codes mentioned

2055020551205522055320600206042060520606206102061120612M79.0M79.10M79.18M79.7M12.9M35.2A52.16A52.78A54.42A54.49E08.610E08.618E09.618E10.618E13.618M05.7AM06.0AM08.9AM19.09M19.29M65.90M65.98M65.99M65.911M65.912M65.919M65.921M65.922M65.929M65.931M65.932M65.939M65.941M65.942M65.949M65.951M65.952M65.959M65.961M65.962M65.969M65.971M65.972M65.979M86.9

Original notice

Trigger Point Injections
bcbsms.com · Always check the source before changing claims.
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