Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

Subcutaneous allergen immunotherapy (SCIT) with aeroallergens is covered for patients with allergic rhinitis/conjunctivitis, allergic asthma, combined upper and lower allergic respiratory disease, and for moderate–severe dust-mite atopic dermatitis after failure of medical therapy. Coverage requires clinically relevant symptoms on natural exposure, demonstrated allergen-specific IgE (skin test or serum), and at least one qualifying reason (e.g., >=28 days poor response to pharmacotherapy or unacceptable medication adverse effects); treatment typically comprises a 3–5 year maintenance course with periodic (6–12 month) evaluations and will not be reimbursed if no clinical benefit is evident after 2 years.

"SCIT using aeroallergen preparations is reasonable and necessary for allergic rhinitis and/or allergic conjunctivitis (seasonal, perennial, or both)."

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