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CPT 95115: Allergen Immunotherapy, Single Injection
CPT code 95115 denotes the professional service of administering a single allergenic extract injection for immunotherapy (desensitization) during a patient visit. This code captures a common component of allergy treatment used to reduce sensitivity to specific environmental or venom allergens and is relevant across outpatient allergy and immunology practices nationally.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for this service, how it is reported in professional billing, and where it fits relative to related allergen immunotherapy codes. The publication outlines typical sites of service and the common clinical indications that prompt use of this code, such as allergic rhinitis, chronic allergic conjunctivitis, and venom allergy encounters.
The material highlights billing relationships between single-injection reporting (95115) and related services covering multiple injections or antigen preparation, supplying clarity for coding and documentation. It also provides national-level benchmarking context and notes of interest for payers and provider administrators regarding reimbursement classification and code adjacency. Data not available in the input is explicitly identified where applicable.
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Billing Code Overview
CPT code 95115 describes a single administration of an allergenic extract by injection during a patient visit. The service is allergen immunotherapy (desensitization) consisting of a single injection of antigenic material intended to reduce sensitivity to specific allergens.
Service Type: Allergen immunotherapy — single injection
Typical Site of Service: Office or clinic setting, such as an allergist or immunology clinic where injections are administered and patients are observed briefly after the injection.
National Reimbursement Benchmarks
National averages show a clear split: Medicare’s mean rate of $10.7 sits well below BUCA’s average commercial mean of $42.1, indicating that commercial arrangements captured by BUCA pay roughly four times Medicare on average for CPT 95115. Blue Cross Blue Shield and UnitedHealth Group also post higher means ($63.2 and $15.4 respectively) than Medicare, while Aetna and Cigna cluster closer to Medicare’s level.
Dispersion varies notably across payers. Blue Cross Blue Shield has one of the widest interquartile spreads with P75–P25 = $24.5, signaling greater variability in contract rates, while Aetna’s spread is tighter at $7.0. UnitedHealth Group and Cigna show moderate spreads of $9.1 and $8.2 respectively. BUCA’s interquartile spread is $14.5 and Medicare’s is narrow at $1.0, indicating relatively consistent local Medicare rates.