Allergy Testing

Medicare covers in vivo allergy testing (immediate IgE-mediated and delayed cell-mediated) and select in vitro allergen-specific IgE testing when supported by medical evidence and when a documented history and physical indicate probable exposure. Percutaneous skin testing is the preferred method for immediate hypersensitivity (inhalant, food, venom, penicillin); intradermal, patch, photo, mucous membrane, bronchial challenge, and ingestion challenge tests are covered in specified clinical situations, with in vitro testing allowed only as a documented substitute when skin testing is not possible or reliable. Several procedures and tests are explicitly limited or denied (e.g., home-based ingestion challenges, provocative tests, qualitative multiallergen screens, and testing for listed noncovered antigens), and testing frequency/extent must be judiciously justified in the medical record.

"Allergy testing for immediate (IgE-mediated) and delayed (cell-mediated) hypersensitivity is covered when supported by scientifically valid peer-reviewed medical studies."