According to their website you need either a US checking account or debit card, so for all intents and purposes, yes.

If you're in (certain parts of) Europe, Revolut will offer you one-time use virtual debit cards if you're on one of their paid plans. However, I have no personal experience with them. Being limited to one transaction each makes them a lot less interesting in my opinion, since I can't set up my subscriptions through different cards.

You can have a virtual CC ( or more but didnt check ) with Revolut that can be one time use or multiple, its all up to you for how long You want to use it.

I recently looked into them. You can have up to 5 on their premium plan. But these are still "normal" debit cards with no limits beyond the funding of your account.

The service that privacy.com offers is different in that it allows you to control very precisely what kind of charges are allowed on any of your virtual cards (and allows you to have more than five). If I used a particular card only for Spotify, I could put a $10/month limit on it, for example. This is more akin to the one-time card offering, but it's not quite the same since it doesn't support recurring payments.

On that note: if anyone is aware of a service like privacy.com available to users in mainland Europe, I'd be very interested to hear about it.