Allergy Immunotherapy
L32553
Covered: subcutaneous allergen immunotherapy is covered for IgE‑mediated allergic rhinitis/conjunctivitis, allergic asthma, stinging insect hypersensitivity (venom immunotherapy for insect anaphylaxis), specified rapid desensitizations (e.g., insulin, penicillin, horse serum, sulfonamides, cephalosporins) and common aeroallergens (pollen, dust mite, mold, animal dander, cockroach); excluded/investigational are poison ivy/oak/sumac desensitization, whole‑body hymenoptera extracts (except venom/fire ant), food extract immunotherapy, bacterial vaccine desensitizations, intracutaneous RIT, neutralization/repository emulsion therapies, sublingual/provocative therapies, and immunotherapy for urticaria or Candida vulvovaginitis. Key requirements: documented specific IgE by immediate skin test or in‑vitro testing, administration under a physician trained to recognize/treat anaphylaxis in a properly equipped facility (home self‑administration only rarely with informed consent), documentation of MD‑prepared antigen stability, clinical benefit documented (lack of benefit after 12–24 months or no benefit after 2 years supports discontinuation), and for rapid desensitization continuous monitoring and documentation of indication and prior reactions.