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

CPT 95165 covers physician preparation and provision of antigen extracts for subcutaneous allergen immunotherapy when prepared by an MD/DO who has examined the patient and established a treatment plan; injection is billed separately. Billing is limited by vial volume (generally a maximum of 1 dose per cc as calculated for practice expense: e.g., up to 10 doses for a 10 cc vial, bill actual aliquots if <10 cc, and up to a 12-month supply may be prepared), and maintenance claims require the EJ modifier; same-day office visit codes with injection codes are allowed only if a separately identifiable service is documented.

"CPT code 95165 may be reported for the physician's preparation and provision of antigen extracts for allergen immunotherapy (SCIT)."

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