Allergy Testing and Immunotherapy / Medicare's words on allergy testing

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reproduces CMS manual language on allergy testing and immunotherapy under Medicare. It covers how the policy addresses billing structure, units and dose reporting, venous and non-venous antigen preparation, same-day visit considerations, and a reference to related supply coverage guidance. It is useful for coders, billers, and compliance staff working with Medicare allergy and immunotherapy claims.

Why This Topic Matters

The page helps readers understand Medicare’s published framework for reporting allergy testing and immunotherapy services and the surrounding claim-processing rules. It is relevant for avoiding misbilling, aligning claims with CMS manual guidance, and locating the Medicare policy context for these services.

Article Sections

  1. 200 - Allergy Testing and Immunotherapy

    Introduces the CMS manual section and its effective-date context for allergy testing and immunotherapy policy.

  2. A. Allergy Testing

    Covers Medicare’s general payment framework for allergy testing services and claim reporting concepts.

  3. B. Allergy Immunotherapy

    Discusses Medicare policy for allergen immunotherapy services, including antigen preparation, injection services, unit reporting, and related billing treatment.

  4. C. Allergy Shots and Visit Services on the Same Day

    Addresses Medicare guidance for reporting allergy injection services with same-day visit services and the applicable claim-processing framework.

  5. D. Reasonable Supply of Antigens

    Points to related CMS coverage guidance on antigen supply considerations in the Medicare manual system.

What You Will Learn

  • The Medicare policy areas covered for allergy testing and immunotherapy
  • How the article organizes billing and claim-reporting guidance for allergy services
  • Which CMS manual references are connected to same-day visit and antigen supply topics
  • The types of coding and payment issues Medicare addresses for allergen immunotherapy claims

Who Should Read This

  • Medical coders
  • Medical billers
  • Compliance staff
  • Revenue cycle professionals
  • Allergy and immunology practices

Codes Discussed

Code Ranges Discussed

  • CPT: 95004-95078
  • CPT: 95120 THROUGH 95134
  • CPT: 95144 THROUGH 95170
  • CPT: 95115 THROUGH 95117
  • CPT: 95115 THROUGH 95199

Modifiers Discussed


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