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

CPT 95165 covers physician preparation and provision of non-venom antigen extracts, including calculations based on prior skin tests and history, when prepared by an MD/DO who has examined the patient and established a treatment plan and dosage regimen. Billing is limited by vial volume (one billable dose per 1 cc, with a 10-dose PE cap per 10 cc vial unless larger vial volume justifies more), a reasonable supply limit of up to 12 months, and requires modifier EJ for maintenance; injections are billed separately (e.g., 95115/95117) and same-day E/M billing requires documentation of a separately identifiable service.

"CPT 95165 covers the physician's preparation and provision of non-venom antigen extracts, including calculation of concentration and volume based on the patient's prior skin test results and person..."

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