Billing and Coding: Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

CPT 95165 covers physician professional services for preparation and provision of non-venom allergen antigen extracts when an MD/DO has examined the patient and determined a treatment plan and dosage regimen; the number of doses must be specified. Billing is limited by vial-based dose rules (generally max 10 doses per 10 cc vial, bill actual cc content if <10 cc), a reasonable supply is defined as up to a 12-month supply, injections are billed separately, and maintenance claims require modifier EJ.

"CPT 95165 may be billed for professional preparation and provision of non-venom allergen antigen extracts (specify number of doses) when the physician prepares the antigen and determines the dosage..."

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