This FAQ page is designed to help clarify and provide accurate information regarding asthma and allergies. We will continue to update this list as new information becomes available.
What procedure codes will I need to provide my insurance company?
The codes for immunotherapy are 95115 (single injection), 95117 (multiple injection) and 95165 (serum preparation).
What questions should I ask the insurance company?
Because immunotherapy is very plan specific, here is what you should ask your insurance company: First, are the above codes covered? Second, will these charges go toward your deductible or co-insurance? Third, will there be a co-pay?
What is the cost before insurance?
The cost for a single injection (95115) is $26 each visit and the cost for multiple injections (95117) is $34 each visit. Serum preparation (95165) is $36 for each UNIT billed.
How is serum billed?
The initial serum preparation charge covers the cost to formulate the buildup phase of your first 30 injections (allergy shots). This is a one-time charge for your build-up phase. Most patients get through build-up phase serums in 6 months, and then enter a maintenance phase.
- Build-up phase serum charge: $1,080 per allergy shot series (30 injections)
- Maintenance phase serum charge: $396 per allergy shot series (11 injections)
The cost listed is for each allergy shot series.
For example: Your physician starts you on 2 allergy shots, which means you would be administered 2 injections every time you come in.
- Allergy shot 1 (contains trees, grass, weeds, dog): $1,080 charge for buildup phase, then $396 charge for each set of serum refills thereafter.
- Allergy shot 2 (contains mold, dustmite, ragweed): $1,080 charge for buildup phase, then $396 charge for each set of serum refills thereafter.
Therefore the initial one-time serum preparation charge will be $2,160 (2 x $1,080) for the first 30 visits.
The subsequent maintenance charge will be $792 (2 x $396) for every 11 visits thereafter.
If there are additional questions, please contact our billing office (402-397-7400 opt. 4)