AmeriHealth will introduce a new medical policy to apply frequency limit periods for the use of trigger point injections in the treatment of myofascial pain syndrome. Myofascial trigger points are self-sustaining hyper-irritative foci that may occur in any skeletal muscle in response to strain produced by acute or chronic overload.

Medical policy #11.14.02n: Trigger Point Injections was posted as a Notification on January 2, 2019, and will go into effect April 1, 2019. AmeriHealth will apply a frequency limit period for the use of trigger point injections in the treatment of myofascial pain syndrome. There will be a maximum of ten injection sessions in a 12-month calendar year.

Note: Administration of injection services to a particular site, regardless of the number of injections, is considered one session.

More information

For more information about the frequency limits on injection sessions, please refer to the Notification for this policy on our Medical Policy Portal, select Accept and Go to Medical Policy Online, and then select Active Notifications.