FAQ

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)