HB 457: Occupational therapists; perform dry needling as a physical agent modality if certain training and education requirements are met; authorize

Under current Georgia law, occupational therapists can use physical agent modalities like heat, water, and light for treatment, but dry needling (inserting thin needles to stimulate muscles and connective tissue) is not listed among them. House Bill 457 changes that by adding dry needling to the definition of physical agent modalities and creating a legal definition distinguishing it from acupuncture. The bill sets strict conditions before a therapist can perform dry needling: they must already be certified in physical agent modalities, have at least three years of clinical experience (unless the licensing board accepts less based on specific coursework), and complete detailed postgraduate coursework covering anatomy, pain mechanisms, and safety. Therapists need at least 28 hours of postgraduate instruction, mostly in person, to needle upper extremities, and an additional 40 hours to needle lower extremities. Online instruction generally does not count. Patients must sign informed consent forms describing the risks, benefits, and the therapist's training before treatment can occur.

• Adds a legal definition of 'dry needling' to Georgia's occupational therapy law, distinguishing it from acupuncture.
• Adds dry needling to the list of physical agent modalities occupational therapists are authorized to use.
• Requires therapists to hold at least three years of clinical experience, or documented dry needling coursework, before performing the technique.
• Sets minimum training hours: 28 hours (22 in person) for upper extremity dry needling, plus 40 more in-person hours for lower extremities.
• Bars online instruction from counting toward training, except for remote or self-study components of postgraduate coursework.
• Requires therapists to obtain a patient's signed informed consent, documenting risks, benefits, and the therapist's training, before performing dry needling.

Licensed occupational therapists in Georgia who want to add dry needling to their practice, the state occupational therapy licensing board that must approve training courses and write new rules, and patients who would need to sign informed consent before receiving dry needling treatment.

Patients seeking occupational therapy for muscle or movement problems could gain access to dry needling as a treatment option, while therapists face new training and documentation hurdles before they can offer it. The bill also sets a clear legal line separating dry needling from acupuncture practice.

• Section 1 amends O.C.G.A. § 43-28-3 to define 'dry needling' as using a thin filiform needle to stimulate neural, muscular, and connective tissue, explicitly excluding acupuncture.
• Section 1 also adds dry needling to the list of physical agent modalities occupational therapists may use under O.C.G.A. § 43-28-3(12).
• Section 2 amends O.C.G.A. § 43-28-8 to require certification in physical agent modalities and at least three years of clinical experience (with board discretion to reduce this) before performing dry needling.
• Section 2 requires documented coursework on musculoskeletal and neuromuscular systems, pain mechanisms, trigger point theory, and universal precautions, plus postgraduate instruction on safety, contraindications, and evidence-based dry needling theory.
• Section 2 sets minimum training hours: 28 hours (22 in-person) for upper extremities, and an additional 40 in-person hours for lower extremities.
• Section 2 requires signed patient informed consent describing risks, benefits, and the therapist's training before dry needling can be performed.
• Section 2 directs the licensing board to write rules and regulations governing use of physical agent modalities, including dry needling.
• Section 3 repeals any conflicting Georgia laws.

1. 2025-02-19House Second Readers (House)
2. 2025-02-18House First Readers (House)
3. 2025-02-13House Hopper (House)

• Mitchell Horner (R, HD-003)Primary sponsor
• Alan Powell (R, HD-033)
• Kasey Carpenter (R, HD-004)
• Jordan Ridley (R, HD-022)
• Rick Jasperse (R, HD-011)

• dry needling
• occupational therapy
• medical licensing
• physical therapy regulation
• patient consent