Summary
BCBSMS updated its Allergy Testing policy, and the policy history records the update on 04/01/2026. The first policy statement now gives general guidelines for when allergy testing should be performed, and the double blind food challenge criteria changed. Repeat skin testing in children now includes reevaluation criteria for food allergies, and adults may have repeat testing when they develop increased atopic symptoms suggesting new sensitizations.
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What to do
Action · 5 steps
01The policy gives no separate effective date for the 04/01/2026 update, so check current applicability before acting.
02Billing team: for oral food challenges (CPT 95076 and 95079), confirm the documentation shows one of the listed clinical settings, such as a food highly suspected to have caused a significant acute allergic reaction when specific IgE testing is negative, or a food highly suspected as an allergen when elimination has not resolved symptoms.
03Billing team: bill repeat skin testing only when the chart clearly documents an indication, such as a child who developed pollen and outdoor mold sensitivities after earlier food and indoor exposures, an adult who needs reevaluation after three to five years of venom immunotherapy, or an adult who developed increased atopic symptoms suggesting new sensitizations.
04Routine re-testing for the same allergens without a new clinical presentation is considered not medically necessary.
05Skin tests are limited to 50 percutaneous and up to 20 intracutaneous tests per day.
Codes mentioned
9507695079950049501795018950249502795028
Original notice
Allergy Testing
bcbsms.com · Always check the source before changing claims.