Updated environmental allergen immunotherapy policy

Beginning Jan. 1, 2023, we will no longer cover home and self-administered subcutaneous allergen immunotherapy. This will apply to all UnitedHealthcare commercial plan members, and we’ll update the environmental allergen immunotherapy medical policy to reflect this change.

Reason for the policy update

We recently reviewed the home-and self-administered subcutaneous allergen immunotherapy and we’ve determined that home-and self-administered subcutaneous allergen immunotherapy is not medically necessary because the safety and effectiveness of this therapy hasn’t been established.

What this means for you

Starting Jan. 1, 2023, there will only be coverage for claims with serum mixtures of environmental allergen immunotherapy, with CPT® codes 95165 or 95199, when they’re prepared and administered in a clinician’s office under the supervision of a trained medical professional as outlined in the medical policy.  

Learn more

You can view the updated medical policy on Jan. 1, 2023, by visiting UHCprovider.com/policies and searching for “environmental allergen immunotherapy.” 

We’re here to help

If you have questions, please contact us. 

CPT® is a registered trademark of the American Medical Association

Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Health plan coverage provided by UnitedHealthcare of Arizona, Inc., UHC of California DBA UnitedHealthcare of California, UnitedHealthcare Benefits Plan of California, UnitedHealthcare of Colorado, Inc., UnitedHealthcare of the Mid-Atlantic, Inc., MAMSI Life and Health Insurance Company, UnitedHealthcare of New York, Inc., UnitedHealthcare Insurance Company of New York, UnitedHealthcare of Oklahoma, Inc., UnitedHealthcare of Oregon, Inc., UnitedHealthcare of Pennsylvania, Inc., UnitedHealthcare of Texas, Inc., UnitedHealthcare Benefits of Texas, Inc., UnitedHealthcare of Utah, Inc., UnitedHealthcare of Washington, Inc., Optimum Choice, Inc., Oxford Health Insurance, Inc., Oxford Health Plans (NJ), ¬Inc., Oxford Health Plans (CT), Inc., All Savers Insurance Company, or other affiliates. Administrative services provided by OptumHealth Care Solutions, LLC, OptumRx, Oxford Health Plans LLC, United HealthCare Services, Inc., or other affiliates. Behavioral health products provided by U.S. Behavioral Health Plan, California (USBHPC), United Behavioral Health (UBH), or its affiliates. 

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