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

CPT 95165 is payable for physician preparation of non-venom allergen extracts for SCIT when an MD/DO has examined the patient and documented a treatment plan; the code covers preparation/calculation but not administration. Billing is limited by vial volume (generally 1 dose per 1 cc with a PE-based cap of 10 doses for a 10 cc vial), a recommended maximum of a 12-month supply prepared at one time, and compliance with NCCI/MUE edits; maintenance claims require modifier EJ and same-day office visits are billable only if a separately identifiable service is documented.

"CPT 95165 may be billed for the physician preparation of vials of non-venom antigens for subcutaneous allergen immunotherapy (SCIT) when the physician performs calculations for concentration and vo..."

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