CPT 95199: Unlisted Allergy/Immunology Procedure

CPT code 95199 is used to report unlisted procedures in allergy and immunology when there is no specific CPT code for the service, typically covering diagnostic or therapeutic allergy testing or immunotherapy procedures; service type: allergy/immunology procedures; typical site of service: allergist or immunology clinic, outpatient facility, or physician office.

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CPT 95199: Unlisted Allergy/Immunology Procedure

Customize your policy alerts

Sign up for cpt 95199 policy alerts

Get alerted when payer policies referencing 95199 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A 34-year-old patient with a history of severe multiple aeroallergen sensitivities presents to an allergy/immunology clinic for a service not described by an existing CPT code. The patient requires a specialized diagnostic or therapeutic procedure — for example, custom preparation and administration of an investigational allergen extract, complex component-resolved testing not covered by standard panels, or a novel desensitization protocol involving unique dosing schedules and monitoring. The clinical workflow begins with evaluation by an allergist (history, focused exam, review of prior test results), ordering the specialized procedure, obtaining informed consent, preparing individualized materials or protocols in the clinic or laboratory, performing the procedure (which may include monitored administration, serial challenge exposures, or specimen handling), and post-procedure observation with documentation of response and any adverse events. Billing uses 95199 to report the unlisted allergy/immunology procedure; documentation must clearly describe the procedure, time, resources used, and clinical rationale to support medical necessity and to enable payer review.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`95004`	Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction; first 20 tests	Commonly performed for initial skin prick testing prior to or instead of an unlisted specialized diagnostic test.
`95024`	Intradermal tests, sequential and incremental, with allergenic extracts, single dilution; first test	Used when intradermal testing is required; may precede or complement unlisted procedures when standard codes apply to parts of the evaluation.
`95115`	Professional services for allergen immunotherapy not required to be reported by CPT (single injection)	Related to administration of allergen immunotherapy; parts of a complex immunotherapy regimen might be billed with `95199` if not otherwise described.
`95070`	Patch or application test	Performed for contact allergens; may be used alongside unlisted procedures when specialized contact testing is customized.
`96372`	Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)	Used for administration of medications associated with desensitization or challenge protocols that are part of a complex unlisted allergy procedure.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiovascular Disease Physician	An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
385H00000X	Respite Care	Respite Care Facility · Respite Care
125K00000X	Advanced Practice Dental Therapist	An Advanced Practice Dental Therapist is:<br/>(1) A dental therapist who has completed additional training beyond basic dental therapy education and p…
125J00000X	Dental Therapist	A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
261QM1000X	Migrant Health Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
J30.0	Vasomotor rhinitis
J30.1	Allergic rhinitis due to pollen
J30.2	Other seasonal allergic rhinitis
J30.9	Allergic rhinitis, unspecified
J45.21	Mild intermittent asthma with (acute) exacerbation
J45.22	Mild intermittent asthma with status asthmaticus
J45.901	Unspecified asthma with (acute) exacerbation
J45.909	Unspecified asthma, uncomplicated
K52.9	Noninfective gastroenteritis and colitis, unspecified
L20.84	Intrinsic (allergic) eczema

Showing 1–10 of 26

CPT 95115: Allergen Immunotherapy, Single Injection

CPT-95117-ALLERGY-IMMUNOTHERAPY-MULTIPLE-INJECTIONS

CPT 95117: Allergen Immunotherapy, Multiple Injections

CPT-95120-ALLERGEN-IMMUNOTHERAPY-SINGLE-INJECTION

CPT 95120: Allergen Immunotherapy, Single Subcutaneous Injection

CPT-95125-ALLERGEN-IMMUNOTHERAPY-MULTIPLE-INJECTIONS-SESSION

CPT 95125: Allergen Immunotherapy, Multiple Injections

CPT-95130-STINGING-INSECT-VENOM-ADMINISTRATION-OFFICE

CPT 95130: Stinging Insect Venom Immunotherapy, Single Insect

CPT-95131-STINGING-INSECT-VENOM-ADMINISTRATION-TWO-INSECTS-OFFICE

CPT 95131: Stinging Insect Venom, Two-Species Administration

CPT-95132-VENOM-IMMUNOTHERAPY-STINGING-INSECT-THREE-SPECIES

CPT 95132: Stinging Insect Venom Immunotherapy for Three Insects

CPT-95133-STINGING-INSECT-VENOM-IMMUNOTHERAPY-OFFICE-ADMINISTRATION

CPT 95133: Stinging Insect Venom Immunotherapy for Four Insects

CPT-95134-VENOM-IMMUNOTHERAPY-FIVE-INSECT-VENOMS-OFFICE-ADMINISTRATION

CPT 95134: Stinging Insect Venom Immunotherapy Administration

CPT-95144-ALLERGEN-IMMUNOTHERAPY-ANTIGEN-PREPARATION-SINGLE-DOSE-VIALS

CPT 95144: Allergen Immunotherapy Antigen Preparation, Single-Dose Vial

Showing 1–10 of 18

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`95004`	Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction; first 20 tests	Commonly performed for initial skin prick testing prior to or instead of an unlisted specialized diagnostic test.
`95024`	Intradermal tests, sequential and incremental, with allergenic extracts, single dilution; first test	Used when intradermal testing is required; may precede or complement unlisted procedures when standard codes apply to parts of the evaluation.
`95115`	Professional services for allergen immunotherapy not required to be reported by CPT (single injection)	Related to administration of allergen immunotherapy; parts of a complex immunotherapy regimen might be billed with `95199` if not otherwise described.
`95070`	Patch or application test	Performed for contact allergens; may be used alongside unlisted procedures when specialized contact testing is customized.
`96372`	Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular)	Used for administration of medications associated with desensitization or challenge protocols that are part of a complex unlisted allergy procedure.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiovascular Disease Physician	An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threaten…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
385H00000X	Respite Care	Respite Care Facility · Respite Care
125K00000X	Advanced Practice Dental Therapist	An Advanced Practice Dental Therapist is:<br/>(1) A dental therapist who has completed additional training beyond basic dental therapy education and p…
125J00000X	Dental Therapist	A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
261QM1000X	Migrant Health Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
J30.0	Vasomotor rhinitis
J30.1	Allergic rhinitis due to pollen
J30.2	Other seasonal allergic rhinitis
J30.9	Allergic rhinitis, unspecified
J45.21	Mild intermittent asthma with (acute) exacerbation
J45.22	Mild intermittent asthma with status asthmaticus
J45.901	Unspecified asthma with (acute) exacerbation
J45.909	Unspecified asthma, uncomplicated
K52.9	Noninfective gastroenteritis and colitis, unspecified
L20.84	Intrinsic (allergic) eczema

Showing 1–10 of 26

CPT 95115: Allergen Immunotherapy, Single Injection

CPT-95117-ALLERGY-IMMUNOTHERAPY-MULTIPLE-INJECTIONS

CPT 95117: Allergen Immunotherapy, Multiple Injections

CPT-95120-ALLERGEN-IMMUNOTHERAPY-SINGLE-INJECTION

CPT 95120: Allergen Immunotherapy, Single Subcutaneous Injection

CPT-95125-ALLERGEN-IMMUNOTHERAPY-MULTIPLE-INJECTIONS-SESSION

CPT 95125: Allergen Immunotherapy, Multiple Injections

CPT-95130-STINGING-INSECT-VENOM-ADMINISTRATION-OFFICE

CPT 95130: Stinging Insect Venom Immunotherapy, Single Insect

CPT-95131-STINGING-INSECT-VENOM-ADMINISTRATION-TWO-INSECTS-OFFICE

CPT 95131: Stinging Insect Venom, Two-Species Administration

CPT-95132-VENOM-IMMUNOTHERAPY-STINGING-INSECT-THREE-SPECIES

CPT 95132: Stinging Insect Venom Immunotherapy for Three Insects

CPT-95133-STINGING-INSECT-VENOM-IMMUNOTHERAPY-OFFICE-ADMINISTRATION

CPT 95133: Stinging Insect Venom Immunotherapy for Four Insects

CPT-95134-VENOM-IMMUNOTHERAPY-FIVE-INSECT-VENOMS-OFFICE-ADMINISTRATION

CPT 95134: Stinging Insect Venom Immunotherapy Administration

CPT-95144-ALLERGEN-IMMUNOTHERAPY-ANTIGEN-PREPARATION-SINGLE-DOSE-VIALS

CPT 95144: Allergen Immunotherapy Antigen Preparation, Single-Dose Vial

Showing 1–10 of 18

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 95199: Unlisted Allergy/Immunology Procedure

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CPT 95199: Unlisted Allergy/Immunology Procedure

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

CPT 95199: Unlisted Allergy/Immunology Procedure

Sign up for cpt 95199 policy alerts

CPT 95199: Unlisted Allergy/Immunology Procedure

Sign up for cpt 95199 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What is CPT 95199 and when should it be used?

What documentation is required when billing 95199?

Which modifiers are commonly used with 95199 and what do they indicate?

Are there specific CPT codes related to 95199 that I should consider using?

Which providers, sites of service, and payers are relevant for billing 95199?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What is CPT 95199 and when should it be used?

What documentation is required when billing 95199?

Which modifiers are commonly used with 95199 and what do they indicate?

Are there specific CPT codes related to 95199 that I should consider using?

Which providers, sites of service, and payers are relevant for billing 95199?

References