CPT Code 95117: Allergen Immunotherapy - Multiple Injections

What is the CPT Code 95117: Allergen Immunotherapy, Two or More Injections?

CPT Code 95117 is used to report allergen immunotherapy services involving multiple injections—specifically, two or more given during a single patient encounter. This code applies to the administration only and does not include antigen preparation. For extract preparation, use CPT Code 95165, which represents the provision of antigens (including multi-dose vials or single-dose vials) prepared for allergy immunotherapy.

This code is most commonly associated with subcutaneous allergy immunotherapy (SCIT), such as for environmental allergens or venom immunotherapy (e.g., wasp venom, fire ant extract, or more than one venom), when multiple injections are medically necessary.

The 95117 CPT code identifies the professional services provided when two or more allergy injections are administered during the same encounter. It does not include allergy testing, antigen preparation, or evaluation and management services.

The Medicare Physician Fee Schedule (MPFS) continues recognizing 95117 for allergen immunotherapy injections. However, Medicare Administrative Contractors (MACs) emphasize compliance with medical necessity and correct reporting of services rendered, particularly in catch-up billing situations or when more or fewer doses than expected are administered due to patient reaction or dose adjustment.

Under Medicare Part B, CPT 95117 is reimbursable only when:

• The service is medically necessary
• Documentation confirms that the particular patient received multiple immunotherapy injections
• The appropriate injection code (95117) is paired with antigen codes (e.g., 95165 for allergenic extracts)
• The services are not bundled with other management services unless they are significant and separately identifiable

CPT Code 95117 documentation requirements

The 2025 ACAAI, AAAAI, and AAOA guidelines clarify reasonable documentation for CPT code 95117. This supports compliance while minimizing the burden of overdocumentation.

Required:

• Patient name and date of birth
• Date of injection
• Dose (e.g., volume, dilution) and number of injections
• Injection site(s) (e.g., right arm)
• Initials or signature of the provider who administered the dose

Not required:

• Credentials of the provider
• Specification of subcutaneous route (standard for this code)
• Vial expiration dates
• Full treatment boards or planned dosing schedule
• History of previous doses
• Same physician signature (if administration was delegated)
• More than ten preparations or more than one vial in the note

Important: Considered single-dose codes (like CPT 95165) should not be confused with injection codes like 95117. Always report single-dose vials separately from the injection procedure code.

CPT Code 95117 billing guidelines

When billing 95117, follow these 2025 billing best practices:

• Do not report 95117 with 95115 (single injection) on the same encounter
• Use CPT code 95165 for the antigen preparation, not 95117
• A separately identifiable visit service may be billed with a modifier -25 if warranted (e.g., E/M for patient evaluation)
• Do not bill CPT 95117 with vaccine administration codes
• For venom immunotherapy, report higher venom codes only if more than one venom (e.g., five venom therapy, four venom therapy) is used during the initial encounter
• For stinging insect venoms, report according to venom doses, venom treatment number, and use codes representing antigens appropriately
• Services rendered must meet medical necessity and be part of a documented immunotherapy plan

Other related codes

Other related codes to CPT 95117 include:

• CPT 95115 (single injection allergen immunotherapy)
• CPT 95116 (single injection, sometimes referenced for single allergen injections)
• CPT 95144 through 95170 (codes for provision and preparation of antigens/allergen extracts)
• CPT 95165 (professional supervision and preparation of allergen extracts)
• CPT 95180 (rapid desensitization)
• CPT codes 95120 through 95134 and 95145 through 95165 (allergen immunotherapy services, though some are non-benefits under specific payers)

Modifiers commonly used with 95117 include:

• Modifier 25 (significant, separately identifiable E/M service)
• Modifier 59 (distinct procedural service)
• Modifier 76 (repeat procedure by same provider)
• Modifier 77 (repeat procedure by different provider)