Md. Code Regs. 10.26.02.08 – Acupoint Injection Therapy.

A. Registration. To obtain the required registration from the Board as qualified to practice acupoint injection therapy, an applicant shall:
1. (1) Possess an active license in good standing to practice acupuncture and East Asian medicine in the State;
2. (2) Successfully complete an NCCAOM, or other appropriate accreditation body endorsed specialty training program and assessment in acupoint injection therapy that consists of at least 60 hours including:
  1. (a) A minimum of 40 hours of theoretical training in the required topics;
  2. (b) A minimum of 20 hours of live face-to-face clinical practical experience; and
  3. (c) Instruction that meets the requirements of §C of this regulation;
3. (3) Possess a current certification by the American Heart Association or approved equivalent in basic life support;
4. (4) Hold a current Clean Needle Technique Certificate through CCAHM or NCCAOM;
5. (5) If licensed in the State for less than 2 years, possess a valid license in good standing to practice acupuncture and East Asian medicine, in any state, for at least 2 years before applying to perform acupoint injection therapy in the State; and
6. (6) Complete and submit an application in the format provided by the Board.
B. The Board shall accept the documentation from a licensee that has completed the training required to perform acupoint injection therapy prior to the effective date of this regulation if:
1. (1) The licensee provides a certificate, or other valid documentation, confirming successful completion of 60 hours of acupoint injection therapy training that complies with this regulation; or
2. (2) The previously completed training does not meet the requirements of this regulation, but the licensee provides documentation of completion of supplemental training that, together with the initial training, fulfills the coursework requirements of §C of this regulation.
C. Training Program Curriculum. The curriculum for the acupoint injection therapy program shall include:
1. (1) 20 hours of clinical practice on a patient or patients;
2. (2) History and development of acupuncture injection therapy;
3. (3) Differential diagnosis;
4. (4) Definitions, concepts, and pathophysiology;
5. (5) The nature, function, channels entered, and contraindications of the substances stated in §F(2) of this regulation;
6. (6) Diseases amenable to treatment with acupuncture injection therapy and the substances appropriate to treat them;
7. (7) Identification of appropriate points for treatment, including palpatory diagnosis;
8. (8) A review of physical examination, anatomy, and referral zones;
9. (9) Universal precautions including management of blood borne pathogens and hazardous waste;
10. (10) Procedures for injections, including preparing the substances, contraindications, and precautions;
11. (11) Administration techniques and equipment required;
12. (12) Administration of the prepackaged substances authorized for acupoint injection therapy, including aseptic technique, recordkeeping and storage of substances prepared and authorized for use in acupoint injection therapy;
13. (13) Safety and emergency procedures; and
14. (14) 2 hours of training in the use of intramuscular epinephrine and emergency oxygen which count toward the required theoretical and clinical training hours.
D. Clinical Instructors. In addition to the requirements of NCCAOM, or other appropriate accreditation body, an instructor for acupoint injection therapy shall:
1. (1) Ensure that the curriculum meets the training requirements set forth under §C of this regulation;
2. (2) Be a licensed practitioner in acupuncture in good standing in the State and be registered to practice acupoint injection therapy in the State;
3. (3) Possess at least 5 years of experience in the practice of acupuncture that includes acupoint injection therapy;
4. (4) Retain proof of compliance as set forth under this section for as long as they provide acupoint injection therapy training; and
5. (5) Provide proof of compliance to the Board upon request.
E. Training Programs. All training programs shall provide each successful student with:
1. (1) A certificate of successful completion of the program;
2. (2) A course syllabus outlining the schedule and curriculum of the program; and
3. (3) Testing requirements and the performance measure for successful completion.
F. Practice.
1. (1) To practice acupoint injection therapy, the licensed acupuncturist shall:
  1. (a) Possess a registration for acupoint injection therapy from the Board;
  2. (b) Explain acupoint injection therapy to the patient in advance of treatment;
  3. (c) Obtain written informed consent specific to acupoint injection therapy that shall be included in the patient’s medical record;
  4. (d) Only perform subcutaneous, intradermal, or intramuscular injection in accordance with the principles of acupuncture;
  5. (e) Have an adverse event or emergency plan in place for allergic reactions to injected substances;
  6. (f) Maintain professional liability coverage for this procedure; and
  7. (g) Only use prepackaged and sterile acupoint injectable therapeutic substances that are:
    1. (i) Acquired from an appropriately licensed entity in compliance with federal and State law; and
    2. (ii) Stored securely and in accordance with manufacturer's specifications.
2. (2) In the practice of acupoint injection therapy, the licensed acupuncturist, provided they have been trained on utilization of the specific therapeutic substance, may only use the following therapeutic substances for acupoint injection therapy:
  1. (a) Sterile and bacteriostatic water;
  2. (b) Saline solution;
  3. (c) Alkalizing agents such as sodium bicarbonate;
  4. (d) Nutritional or dietary substances;
  5. (e) Vitamins and minerals including B-12, B-complex, C, cyanocobalamin, hydroxocobalamin, and methylcobalamin;
  6. (f) Proteins, enzymes, and amino acids including methionine, choline, inositol, and glutathione;
  7. (g) Sugars including dextrose and glucose;
  8. (h) Ozone;
  9. (i) Procaine and lidocaine;
  10. (j) Herbal and botanical extracts including astragalus and Sarapin;
  11. (k) Biological products including hyaluronic acid and epinephrine; and
  12. (l) Homeopathic substances including Traumeel and Zeel.
3. (3) A licensed acupuncturist in the practice of acupoint injection therapy may not:
  1. (a) Administer substances other than those specified under §F(2) of this regulation;
  2. (b) Administer substances that the licensed acupuncturist has not been appropriately trained in accordance with this regulation;
  3. (c) Give an injectable substance to a patient for self-injection; or
  4. (d) Administer intravenous injections.
G. The Board shall maintain a list of all:
1. (1) Licensed acupuncturists registered by the Board as qualified to practice acupoint injection therapy; and
2. (2) Acupoint injection therapy training programs endorsed by the NCCAOM, or other appropriate accreditation body updated at least annually.
H. On or after the effective date of this regulation, unless the person is registered by the Board as qualified to practice acupoint injection therapy, an individual may not:
1. (1) Practice acupoint injection therapy; or
2. (2) Represent to the public that the individual is an acupoint injection therapy registered acupuncturist.
I. Violation of this regulation constitutes unprofessional conduct and may result in disciplinary action as set forth in Health Occupations Article, §4-315, Annotated Code of Maryland.

Authority: Agriculture Article, §§2-301(g) and 2-304; Health Occupations Article, §§1-211, 1A-101, 1A-205, 1A-301,
1A-302, 1A-306, 1A-307, and 1A-316; Annotated Code of Maryland

Effective date:

Regulations .01—.05 adopted as an emergency provision effective February 22, 1996 (23:6 Md. R. 472); adopted permanently effective August 12, 1996 (23:16 Md. R. 1175)

Regulation .02 amended effective October 1, 2001 (28:19 Md. R. 1685)

Regulation .02B amended effective December 11, 2003 (30:24 Md. R. 1741); January 1, 2007 (33:26 Md. R. 1997)

Regulation .03D amended effective March 9, 1998 (25:5 Md. R. 369); December 11, 2003 (30:24 Md. R. 1741)

Regulation .03D, E amended effective October 1, 2001 (28:19 Md. R. 1685)

Regulation .03E amended effective January 1, 2007 (33:26 Md. R. 1997)

Regulation .03G adopted effective February 16, 2004 (31:3 Md. R. 207)

Regulation .05 amended effective October 1, 2001 (28:19 Md. R. 1685); December 11, 2003 (30:24 Md. R. 1741)

Regulation .05E amended effective April 11, 2005 (32:7 Md. R. 681)

Regulation .05F amended effective January 1, 2007 (33:26 Md. R. 1997)

Regulation .06 adopted as an emergency provision effective December 5, 1997 (24:26 Md. R. 1752); adopted permanently effective May 4, 1998 (25:9 Md. R. 680)

Regulation .06A amended effective January 1, 2007 (33:26 Md. R. 1997)

Regulation .06B amended effective February 22, 1999 (26:4 Md. R. 273)

Regulation .07 adopted effective June 15, 1998 (25:12 Md. R. 947)

Regulation .07A amended effective January 1, 2007 (33:26 Md. R. 1997)

Regulation .08 adopted effective June 15, 1998 (25:12 Md. R. 947)

Regulation .08A, D amended effective January 1, 2007 (33:26 Md. R. 1997)

Regulation .09 adopted as an emergency provision effective December 7, 2001 (28:26 Md. R. 2270); emergency status expired June 4, 2002

Regulation .09 adopted as an emergency provision effective June 1, 2002 (29:12 Md. R. 924); adopted permanently effective August 5, 2002 (29:15 Md. R. 1142)

Regulation .09 amended as an emergency provision effective January 19, 2005 (32:3 Md. R. 287); amended permanently effective April 11, 2005 (32:7 Md. R. 681)

Regulation .09 amended effective November 7, 2005 (32:22 Md. R. 1756)

Chapter revised effective April 20, 2009 (36:8 Md. R. 596)

Regulation .02B amended effective December 28, 2009 (36:26 Md. R. 1995); October 16, 2023 (50:20 Md. R. 887); April 13, 2026 (53:7 Md. R 328)

Regulation .03 amended effective April 13, 2026 (53:7 Md. R 328)

Regulation .03D amended effective January 29, 2018 (45:2 Md. R. 69); October 16, 2023 (50:20 Md. R. 887)

Regulation .03E amended effective October 16, 2023 (50:20 Md. R. 887)

Regulation .03F repealed effective October 16, 2023 (50:20 Md. R. 887)

Regulation .03G repealed effective January 29, 2018 (45:2 Md. R. 69)

Regulation .04 amended effective April 13, 2026 (53:7 Md. R 328)

Regulation .04E repealed effective October 16, 2023 (50:20 Md. R. 887)

Regulation .05 amended effective February 20, 2012 (39:3 Md. R. 259); August 5, 2013 (40:15 Md. R. 1229); April 13, 2026 (53:7 Md. R 328)

Regulation .05D amended effective May 12, 2014 (41:9 Md. R. 521)

Regulation .05F amended effective December 28, 2009 (36:26 Md. R. 1995)

Regulation .05F repealed effective October 16, 2023 (50:20 Md. R. 887)

Regulation .06 amended effective April 13, 2026 (53:7 Md. R 328)

Regulation .07 amended effective October 18, 2010 (37:21 Md. R. 1436); October 17, 2011 (38:21 Md. R. 1279); January 7, 2013 (39:26 Md. R. 1665); April 13, 2026 (53:7 Md. R 328)

Regulation .08 adopted effective April 13, 2026 (53:7 Md. R 328)

Regulation .09 effective April 13, 2026 (53:7 Md. R 328)