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

CPT 95165 covers physician preparation and provision of non-venom allergen extracts (excluding injection), with billing based on the number of doses specified and vial volumes calculated on a 1 cc aliquot basis. Billing is limited by practice-expense dose calculations (generally ≤10 doses per 10 cc vial, pro-rated for other volumes), requires physician preparation and exam with a documented treatment plan, and limits prepared supplies to a reasonable amount (generally ≤12 months); maintenance claims require the EJ modifier and injections (CPT 95115/95117) are billed separately.

"CPT 95165 covers physician preparation and provision of non-venom allergen antigen extracts (includes calculations for concentration and volume) but does not include administration of the antigen."

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