For those who don't know... Allergy shots are typically 1-2 injections administered to the upper arm once a week for a period of years… potentially as long as 5-10 years. These shots are given in an attempt to “cure” a person of their allergies such that after the shots are completed, there will be no more allergies OR the allergies have improved to the point that medications work quite well and taken only when needed. These shots MUST be administered in a medical office.
And as such, that's where the hidden costs behind the allergy shots begin. First, there are the copays involved with EACH allergy shot administered in the office as well as making of the allergy vials themselves. Given you have to be in a medical office to get them, there is also the time, travel, gas, and missed time from work to also take into consideration. At least in our office, we require all patients to have an up-do-date epipen at all times, so there's the prescription cost of this as well.
Ways to minimize or at the very least, anticipate the potential costs involved are as follows:
- Once you get established with the shots (in our office, typically 4 injections), you can get the shots administered in a medical office closer to your place of residence or work (thereby saving time, gas, and travel).
- Ask if it's possible to get the shots at home once you reach maintenance.
- See if you are a candidate for allergy drops (SLIT) which is NOT covered by insurance, but is a fixed cost AND they do not need to be administered in a medical office, but rather the comfort of your home/work.
The CPT codes to inquire with your insurance regarding potential copay amounts are:
95165 (Allergy Vial)
95115 (1 shot)
95117 (2+ shots)
Typically, the copays are much smaller than what you pay for a physician office visit, but rarely is it free.
For more information on allergy shots and testing, click here.
For more information on allergy drops, click here.
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