Allergy & Immunology Billing Services in Pennsylvania

Pennsylvania's healthcare market includes 45,000+ physicians, and allergy & immunology practices here face a payer market dominated by Independence Blue Cross / Highmark on the commercial side and PA HealthChoices on the public payer side. Medicare claims are processed through Novitas Solutions, which applies its own Local Coverage Determinations that directly affect allergy & immunology procedure coverage and medical necessity requirements. Generic billing teams without PA specific knowledge leave revenue on the table.

Allergy & Immunology billing itself is complex. Allergy and immunology billing revolves around allergy testing codes (95004 percutaneous, 95024 intracutaneous, 95044 patch testing), immunotherapy administration (95115-95117 for injections, 95120-95134 for professional services with provision of antigen), biologic medication J-codes for severe allergic conditions, and pulmonary function testing (94010-94070). Test count accuracy is critical — each allergy test is billed per individual allergen, and a typical testing session involves 40-80 individual tests. When you combine this coding complexity with Pennsylvania's specific payer rules, authorization requirements, and 5 PA HealthChoices managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving allergy & immunology practices from Philadelphia to Erie and across Pennsylvania.