A. Dry needling is an invasive procedure that requires referral and direction in accordance with § 54.1-3482 of the Code of Virginia. Referral should be in writing; if the initial referral is received orally, it shall be followed up with a written referral. B. A. Dry needling is not an entry level skill but an advanced procedure that requires additional post-graduate training.
1. The training shall be specific to dry needling and shall include emergency preparedness and response, contraindications and precautions, secondary effects or complications, palpation and needle techniques, and physiological responses.
2. The training shall consist of didactic and hands-on laboratory education and shall include passage of a theoretical and practical examination. The hands-on laboratory education shall be face-to-face.
3. The training shall be in a course approved or provided by a sponsor listed in subsection B of 18VAC112-20-131.
4. The practitioner shall not perform dry needling beyond the scope of the highest level of the practitioner's training.
C. B. Prior to the performance of dry needling, the physical therapist shall obtain informed consent from the patient or the patient's representative. The informed consent shall include the risks and benefits of the technique. The informed consent form shall be maintained in the patient record. D. C. Dry needling shall only be performed by a physical therapist trained pursuant to subsection B A of this section and shall not be delegated to a physical therapist assistant or other support personnel.