January 17, 2019
The unit values for code 95165, Professional services for the supervision of preparation and provision of antigens; single or multiple antigens (specify number of doses), with dates of service 01/01/2019 and after will change to the following amounts:
- Maximum daily frequency of 150 units per day/per patient
- Maximum yearly frequency of 250 units per patient
The billed units reflect the actual number of doses prospectively planned to be administered for a patient’s full course of treatment when the antigen is initially prepared. This change is being made to be more reflective of commercial billing practices. The Claims Editor will start applying the above limits beginning with dates of service 01/01/2019 and after.
The details in the Payment Policy can be accessed through your account on One Health Port.