Summary & Overview
CPT 95148: Preparation of Four-Sting Insect Venom Extracts
CPT code 95148 denotes the professional service of mixing and preparing a specified number of doses of extract composed of four single stinging insect venoms for use in venom immunotherapy. This code matters nationally because venom immunotherapy is a clinically important, potentially life‑saving treatment for patients with systemic allergic reactions to insect stings; accurate coding supports appropriate clinical workflows, reimbursement, and quality tracking across allergy and immunology services. Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service and typical sites of care, plus practical guidance on payer coverage patterns, common modifiers used with this service, and how 95148 fits into allergy service lines. The publication provides benchmarks for utilization where available, notes of relevant policy updates affecting coverage and billing, and contextual clinical information about venom immunotherapy dosing and preparation. Data gaps from the input are clearly identified as "Data not available in the input." The content is intended for clinicians, coding professionals, and revenue cycle staff seeking a national overview of billing considerations and administrative context for CPT code 95148.
Billing Code Overview
CPT code 95148 describes the preparation of a specified number of doses of extract of four single stinging insect venoms. This service involves the mixing and preparation of allergen extracts used for venom immunotherapy targeting stings from four distinct insect species.
-
Service type: Preparation of allergen extracts for venom immunotherapy
-
Typical site of service: Ambulatory clinic or allergy/immunology office where allergen extracts are prepared and administered
Clinical & Coding Specifications
Clinical Context
A 35-year-old patient with a history of systemic allergic reactions to Hymenoptera stings presents to an allergy clinic for initiation or maintenance of venom immunotherapy. The clinic encounter includes review of documented sting reactions, risk assessment, and ordering the appropriate venom extracts. The provider mixes and prepares a specified number of doses of four single stinging insect venoms (for example: honeybee, yellow jacket, hornet, and wasp) in the pharmacy or procedure room according to manufacturer and institutional protocols. The prepared extracts are labeled, stored, and readied for administration by nursing staff during the same visit or retained in the clinic’s refrigerated stock for scheduled immunotherapy injections. Typical personnel involved include an allergist/immunologist (or qualified supervised provider), a clinical pharmacist or trained medical assistant who compounds the doses, and nursing staff who administer the injections. Typical site of service is an outpatient allergy clinic, ambulatory infusion center, or hospital outpatient department equipped for allergy immunotherapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician’s interpretation or professional portion related to preparation oversight applies. |
51 |