2025 CPT code 95120
(Active) Effective Date: N/A Revision Date: N/A Medicine - Allergy and Clinical Immunology Procedures Medicine Services and Procedures Feed
Allergen immunotherapy; single injection.
Modifiers 52 (reduced services), 53 (discontinued procedure), 76 (repeat procedure by same physician), 77 (repeat procedure by another physician), and 79 (unrelated procedure) may be applicable in certain scenarios.Consult the CPT manual for specific modifier guidelines.
Allergen immunotherapy is medically necessary for patients with moderate to severe allergic reactions that are not adequately managed with medications.The patient's history, test results and clinical judgment of the physician are crucial in determining medical necessity.
The physician prepares the allergenic extract and administers the injection. This involves assessing the patient's allergies, preparing the appropriate extract, and administering the injection.Monitoring for adverse reactions is also a key responsibility.
In simple words: This code describes a single allergy shot as part of a series of allergy shots.The doctor prepares the allergy medicine and gives one shot during the visit.
Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including the provision of allergenic extract; single injection. This procedure is part of a series of injections administered over time, gradually increasing quantities of a specific allergenic extract to achieve clinical tolerance of those allergens.The code is used when the provider prepares the allergic extracts and administers a single injection at the session.
Example 1: A patient with seasonal allergies to ragweed presents for their first allergy injection.The physician prepares a single injection of ragweed extract and administers it. Code 95120 is reported., A patient with multiple allergies (grass, pollen, dust mites) receives a single injection of a multi-allergen extract.Code 95120 is reported for the single injection., A patient is undergoing maintenance immunotherapy. They receive a single injection of their prescribed allergen extract. Code 95120 is reported.
* Patient's allergy history.* Results of allergy testing (skin prick test, blood test).* Documentation of the allergen extract used (name, concentration).* Documentation of the injection site and any reactions.* Note indicating that this was a single injection.
** This code is used only when a single injection of allergenic extract is administered.For multiple injections, use code 95125.
- Revenue Code: M5D (SPECIALIST - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Allergists/Immunologists, Family Medicine, Pediatrics
- Place of Service:Office, Outpatient Hospital, other appropriate settings.