Bed bugs: how to confirm them and what professional treatment involves

Updated November 10, 2026 · KeystoneProGuide editorial team

How do you know it is bed bugs?

Find the bugs or their traces, not just bites. The EPA says bites are a poor indicator: they look like mosquito or chigger bites or rashes, and some people do not react at all. Look instead for rusty stains on sheets and mattresses, small dark spots of excrement, tiny pale eggs and shed skins, and live bugs. Around the bed, they hide in the piping, seams and tags of the mattress and box spring and in cracks in the frame and headboard. In a heavy infestation they spread to sofa seams, curtain folds, drawer joints, outlets and the edge where wall meets ceiling. The EPA's rule of thumb: if a crack will hold a credit card, it could hide a bed bug.

Confirm the identification before treating. The EPA's first tip is to make sure you have bed bugs, not fleas, ticks or other insects, and it suggests showing a specimen to your local extension agent. Carpet beetles are often mistaken for them.

Are bed bugs dangerous?

The EPA calls them a public health pest. It says they have not been shown to transmit disease, but that bites can cause allergic reactions, rarely severe, and skin infections, and that living with an infestation is linked to anxiety and insomnia.

What does the EPA say to do, and not do?

Its advice for households:

Don't panic, and don't throw everything out. Most belongings can be treated and saved, and discarding them is costly and can spread the bugs. If you do throw out a mattress, slash it so no one takes it home.
Don't reach straight for the spray can. The EPA says to think through treatment options first and follow label directions or hire a professional if pesticides are needed.
Reduce clutter so there are fewer places to hide.
Use encasements on the mattress and box spring and leave them on for a year.
Use the dryer. The EPA says bedding and clothing on high heat for 30 minutes kills bed bugs; washing alone generally does not.
Vacuum carefully and seal the bag in plastic before putting it in an outdoor bin.

It also warns against two home methods. Home freezers may not get cold enough, and turning up the thermostat or using space heaters will not do the job. Bed bugs die at a body temperature of 113 degrees, but a room must get hotter than that for the heat to reach them everywhere. Total release foggers, it says, should not be the only method, and their propellants are flammable.

When should you call a professional?

Early. The EPA advises getting a pest management professional involved as soon as possible, because time spent trying to treat it yourself can let the infestation spread. Finding it early makes treatment far less costly and easier. Choose a company experienced with bed bugs, check its credentials and ask for an integrated pest management approach that includes monitoring for bugs the treatment missed.

What does professional treatment involve?

The EPA says to expect the professional to inspect the home, take furniture apart if needed, and use vacuums, heat and pesticides. Treatment takes time, because bed bugs reproduce quickly and their eggs resist many methods.

Heat. The EPA says heating rooms or items to at least 120 degrees for 90 minutes ensures eggs are killed. For whole-home heat treatment it advises choosing a company with strong references and a record of success, protecting heat-sensitive items, and guarding against bringing bugs back, since heat leaves no residual effect.
Cold. Below 0 degrees for at least 4 days can eliminate some infestations.
Pesticides. The EPA says they should be only one part of the plan. Over 300 products are registered for bed bugs, most for consumer use. Any pesticide used must be labeled for bed bugs and for the place it is applied.
Monitoring. Interceptors under bed legs and encasements help confirm the bugs are gone.

Expect several visits. The EPA says very few infestations are controlled with one treatment, and that your own part, laundering, cleaning and following the preparation list, matters to the result. Bed bugs can also go dormant and look dead for days, then revive.

What does it cost?

HomeAdvisor puts the average at $2,500, with a normal range of $1,000 to $4,000 and up to $6,200 for severe cases; one room runs $300 to $650. HomeGuide gives $300 to $500 per room and $2,500 to $5,000 for a whole house. HomeAdvisor lists heat at $1 to $3 per square foot and chemical treatment at $2 to $5. Ask each company how many visits and follow-up inspections its price includes.

What if you rent, or live in an apartment building?

The EPA tells landlords to inspect promptly, check the units next to an infested one, and not blame the tenant, since often no one is at fault and blame delays reporting. In apartment buildings, it says, building management has to take part too.

In Philadelphia, that is the law. The city's bed bug code requires a landlord to bring in a pest management professional within ten business days of a tenant's notice, treat until no evidence remains, inspect neighboring units in buildings of four or more units, and monitor for 12 months. Tenants must report within five business days and cooperate with preparation. The Philadelphia guide has the details, including who pays.

What a visit involves in general is in what to expect, and prices for other pests are in the cost guide.

Sources

How to Find Bed Bugs, U.S. Environmental Protection Agency
Bed Bugs: A Public Health Issue, U.S. Environmental Protection Agency
Top Ten Tips to Prevent or Control Bed Bugs, U.S. Environmental Protection Agency
Controlling Bed Bugs Using Integrated Pest Management (IPM), U.S. Environmental Protection Agency
Hiring a Pest Management Professional for Bed Bugs, U.S. Environmental Protection Agency
Safety Issues in Controlling Bed Bugs, U.S. Environmental Protection Agency
What Landlords Need to Know about Bed Bugs, U.S. Environmental Protection Agency
Safety Precautions for Total Release Foggers, U.S. Environmental Protection Agency
How Much Does Bed Bug Treatment Cost in 2026?, HomeAdvisor
How Much Does Pest Control Cost?, HomeGuide
Bed Bugs and Property Rental (Philadelphia Code Chapter 9-4800), City of Philadelphia (Philadelphia Code)