Allergen Immunotherapy (AIT) with Subcutaneous Immunotherapy (SCIT)

Allergen immunotherapy with subcutaneous injections (SCIT) using aeroallergen preparations is covered for allergic rhinitis, allergic conjunctivitis, allergic asthma, or combinations thereof when there is a clinically relevant allergic component demonstrated by symptoms with natural exposure and specific IgE testing. Coverage requires prior optimization of environmental controls and pharmacotherapy, demonstrable specific IgE (or positive nasal challenge in select equivocal cases), adherence to provider and facility requirements for antigen preparation and administration, and documentation; an initial maintenance course of 3–5 years is generally recommended with evaluation every 6–12 months and discontinuation/reimbursement stoppage if no benefit after 12–24 months (no reimbursement after 2 years without benefit).

"SCIT with aeroallergen preparations is covered for allergic rhinitis and/or allergic conjunctivitis (seasonal, perennial, or both)."