A New Way to Treat Pain: Occupational Therapists Could Soon Offer Dry Needling in Colorado

What This Bill Actually Does

To understand this bill, it helps to understand the treatment. Dry needling involves inserting thin, solid needles (similar to those used in acupuncture) directly into myofascial trigger points. It is designed to release tight muscle bands, relieve pain, and improve range of motion. Currently in Colorado, physical therapists and acupuncturists can legally perform dry needling, but occupational therapists (OTs)—who often treat the exact same types of musculoskeletal injuries—cannot.

House Bill 26-1042 changes that. Starting September 1, 2027, the bill officially authorizes licensed occupational therapists to perform dry needling on their patients. But the state isn't just handing out needles to anyone with an OT license. The bill builds in strict guardrails to ensure patient safety. An occupational therapist must prove they have the knowledge, skill, and documented competency to perform the procedure. They must also successfully complete a rigorous dry needling course that meets specific educational and clinical prerequisites.

To ensure standards remain high, the bill tasks the Department of Regulatory Agencies (DORA) with writing the official rules for this new authority by June 1, 2027. The legislation explicitly mandates that these new rules must be just as strict as the requirements already in place for physical therapists. Before finalizing anything, DORA's director must also consult with the Colorado Medical Board. Finally, the bill requires occupational therapists to get written informed consent from every single patient. This paperwork must clearly explain the potential benefits and risks of the procedure, and it must include a specific legal disclaimer stating that the occupational therapist is not a licensed acupuncturist.

What It Means for You

If you've ever dealt with a frozen shoulder, severe carpal tunnel syndrome, or a nagging sports injury, you know how crucial occupational therapy is for getting your daily life back on track. Right now, if your OT evaluates you and decides that dry needling would perfectly complement your rehabilitation plan, their hands are tied. They have to refer you out to a physical therapist or an acupuncturist. For you, that means scheduling another appointment, driving across town, paying an additional specialist copay, and trying to coordinate communication between two different healthcare providers.

If HB26-1042 becomes law, you will eventually be able to get this treatment right in your normal OT session. That is a massive win for your wallet and your calendar. By keeping your care under one roof, you streamline your recovery process. However, you will need to be a little patient. Even though the bill is moving quickly this year, the actual authority to perform dry needling doesn't kick in until September 1, 2027. The state needs that gap year to finalize the safety rules and give occupational therapists time to complete their required continuing education courses.

Here are a few concrete steps you can take to prepare for this shift in healthcare access:

• Talk to your provider: If you are currently receiving occupational therapy, ask your therapist if they plan to pursue dry needling certification once the state finalizes the rules next year.
• Check your insurance coverage: Dry needling coverage varies wildly depending on your health plan. Call your insurance provider to find out if they cover the procedure under standard occupational therapy billing codes, or if it requires out-of-pocket payment.
• Track your medical expenses: If you currently pay out-of-pocket for separate acupuncture or physical therapy sessions just for dry needling, calculate what you spend annually so you can budget for consolidating that care with your OT in late 2027.

What It Means for Your Business

For healthcare administrators, clinic owners, and independent occupational therapists, this legislation represents a significant service expansion opportunity. If you run a standalone occupational therapy clinic, you have historically had to refer out patients who needed dry needling, effectively handing revenue over to competing physical therapy practices. If you run a multidisciplinary practice that employs both PTs and OTs, this bill levels the playing field among your staff, allowing for more flexible patient scheduling and cross-coverage.

However, unlocking this new revenue stream will require careful compliance planning. The state is mandating strict oversight. By June 1, 2027, DORA will release the finalized supervisorial, educational, and clinical prerequisites. You will need to budget for your staff to take these continuing education courses, which can be expensive and require time away from the clinic. You will also need to completely overhaul your patient intake paperwork. The law requires a very specific written informed consent document that outlines risks, benefits, and explicitly states the provider is not an acupuncturist. Failing to include that exact phrasing could expose your clinic to disciplinary action.

Here are the action items clinic owners should prioritize to stay ahead of the curve:

• Audit your staff's interest: Survey your occupational therapists this week to find out who actually wants to perform dry needling. Use this headcount to forecast continuing education costs and travel budgets for late 2026 and early 2027.
• Review your malpractice policy: Call your commercial insurance broker and ask how adding dry needling to your OTs' scope of practice will impact your liability premiums. You want to price this into your operating budget now.
• Draft a mock consent form: Start outlining the required informed consent document based on the bill's language. Having a template ready will prevent a last-minute scramble when the final DORA rules drop next year.

Follow the Money

This is one of those rare pieces of healthcare legislation that won't cost Colorado taxpayers a single dime. According to the nonpartisan Legislative Council Staff fiscal note, HB26-1042 requires no state appropriation.

The Department of Regulatory Agencies (DORA) will experience a slight bump in their administrative workload to draft the new rules, conduct public outreach, and process any future patient complaints. However, because DORA already regulates occupational therapists and already manages dry needling rules for physical therapists, they can absorb this extra work using their existing budget. The state might see a tiny trickle of new revenue if an occupational therapist is fined for a disciplinary infraction down the road, but state analysts assume licensed professionals will overwhelmingly comply with the law. For local governments, school districts, and general taxpayers, the financial impact is exactly zero.

Where This Bill Stands

HB26-1042 is sailing through the legislative process with zero friction. Introduced in mid-January by Representatives Lisa Feret and Brandi Bradley, the bill easily cleared the House Health & Human Services committee. On February 18, 2026, it passed the full House of Representatives on its third reading without a single amendment—a strong indicator of broad, bipartisan consensus.

The bill now heads to the Senate, where it is being sponsored by Senator Matt Ball. Given the complete lack of organized opposition, the zero-dollar fiscal note, and the fact that it perfectly mirrors existing physical therapy laws, this bill is on a glide path. Expect it to clear the Senate quickly and land on the Governor's desk well before the legislative session adjourns in May.