Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

Subcutaneous allergen immunotherapy (SCIT) with aeroallergen preparations is covered for patients with allergic rhinitis, allergic conjunctivitis, allergic asthma, or atopic dermatitis due to dust mites when there are symptoms on natural exposure and demonstrable specific IgE, and when additional criteria are met (e.g., ≥28 days failed pharmacotherapy/avoidance or other listed reasons; AD requires ≥90 days failed therapy). Initial maintenance therapy is generally 3–5 years with evaluation every 6–12 months; SLIT, pregnancy, food-sensitivity treatment, venoms, and SCIT without clinically relevant IgE or prior medical/environmental management are not covered. Documentation must include symptom patterns, specific IgE testing (skin or serum), prior treatment trials, physician examination and treatment plan, and supervision/ facility readiness for anaphylaxis; certain equivocal or home-administration cases require case-by-case review and informed consent.

"AIT/SCIT with aeroallergen preparations is reasonable and necessary for patients with allergic rhinitis and/or allergic conjunctivitis (seasonal, perennial, or both) who have symptoms on natural ex..."