Allergy Immunotherapy Injections - CPT 95165 - BCBS RI

Allergy Immunotherapy Injections - CPT 95165 - BCBS RI

   Description:

This policy is to document Blue Cross & Blue Shield of Rhode Island's (BCBSRI) reimbursement process for allergens and immunotherapy CPT codes. BCBSRI will follow the Centers for Medicare and Medicaid Services (CMS) ruling on codes 95115 through 95170 representing the administration of antigens and their preparation and single codes representing both the antigens and their injection.

Allergen immunotherapy is a treatment program for individuals who have hypersensitivity to one or more allergens.The objective of the therapy is to lesson or diminish symptoms when the individual is exposed to the allergen in the future. Immunotherapy consists of injections that contain progressively larger amounts of allergen until the individual reaches and then is able to continue on a maintenance dose level.

Medical Criteria:

Not applicable, this is a reimbursement policy.

Policy:

Allergy injections are a covered benefit.

Coverage:

Benefits may vary between groups/contracts. Please refer to the appropriate evidence of coverage, Subscriber Agreement or RIte Care contract for the applicable office visits allergists benefits/coverage.