Allergy Tests 101: Here are 5 things to Remember
Are you getting the same pattern of sniffles and sneezes every year? Do your eyes water up every time you share a space with a friend’s cat? Medication might provide temporary relief, but some patients benefit immensely from a permanent solution. While animal dander and pollen are the usual suspects when allergies flare up, there are hundreds of possible causes for your allergies. When you can’t determine exactly what’s bothering you, an allergy test could be the solution you’ve been waiting for.
Allergy tests help patients discover allergies to things that they eat, touch, or breathe in. Tests performed by licensed physicians are done either through a blood test or a skin test. A skin test involves pricking or scratching the surface of the skin and applying suspected allergens. This is done usually on the back or forearm and tested with multiple suspected allergens at once. If there is swelling or redness at the site, this confirms the existence of the allergy. A blood test is used when a patient has a severe skin condition such as psoriasis or eczema, very dark skin that prevents the visibility of redness, when a patient is taking medication that could interfere with a skin test. (1) While it is beneficial to confirm the existence of an allergy, tests could end up being a large financial burden without the proper research and preparation beforehand. Here are 5 things to remember before getting an allergy test:
1. Get it from a licensed physician
Many drugstores and supermarkets now offer free screenings and over the counter kits to test yourself. However, these tests are often not reliable. If you carefully read the fine print, these over the counter kits are not certified by the FDA. This means that the makers of the kits do not have the approval of the primary governing body for medical drugs and tests, as they would not want to be liable for any inaccuracies that may result from the test. Quite commonly, the test could result in “false positives”, which say you have an allergy when you do not, leading you to make unnecessary lifestyle changes. (2) Properly licensed allergists and immunotherapists undergo years of training and certification to correctly interpret and control tests, resulting in results that are much more reliable.
2. Allergy tests are priced per allergen.
While there are many different types of allergy tests available, almost every single one is priced per allergen. Itis always in your interest when you suspect an allergy to narrow down the possible causes as much as possible. Keep a record of food and materials you came into contact with in the period before any allergic reactions. Try and think about possible allergens that you came into contact with, as significant reactions are not likely to be from things you come into contact with in your day to day.
3. Even if you’re insured, make sure to consult pricing options beforehand.
The cost of allergy tests range heavily from situation to situation. It is based on a myriad of factors including your provider, your insurance, the deals negotiated between your provider and insurance, and the type of test you take. In some cases, providers may charge up to $400 per allergen, resulting in bills for $11,000 even after insurance coverage. (3) Make sure to consult your provider beforehand about all pricing options to ensure you are getting a reasonable price. The average charge physicians submitted to Medicare was about $16 per allergen in 2016 according to Medicare payment data. (3) When providers set high rates, they do so knowing they’ll ultimate be paid a lower amount, in order to take into account discounts negotiated with your insurance company. Make sure to receive precise numbers rather than qualifiers such as “expensive” or “reasonable”.
4. If your provider does not seem to know specific information, consult your insurance company.
The ultimate cost of your allergy test is not always dependent on your provider. If your provider seems to be unsure about the specific costs, ask your insurance company. Make sure you know what your deductible is, or the amount you pay before insurance will start to contribute. Ask what your co-pay is, or the minimum cost per visit. Most importantly, ask if the allergist is a in-network provider with your insurance, as the pricing structures are very different depending on the answer. If the allergist is not a network provider, then their quote will be final and your insurance will not cover the costs of the test. This is not recommended if you have insurance. If you do not currently have insurance, make sure to negotiate the cost of your care before receiving it, as providers usually offer steep discount to self-pay patients that request them. If your provider is in-network and you currently have health insurance, then you will want to ask what the allowable cost is for the test you’re interested in, the most your allergist can charge you and your insurance (4).
5. There are different types of allergy tests, each with a specific cost.
Each test has a specific Current Procedural Terminology (CPT) code. Skin prick (scratch) tests: CPT code 95004, should cost approximately $5 per allergen and is the cheapest and most common test (4). These tests can test up to 40 allergens simultaneously and is recommended for those scoping for allergies. Intradermal tests: CPT code 95024, are used when skin prick tests are inconclusive and should cost approximately $10 per allergen. An intradermal/scratch combination test: CPT code 95017/95018, are used specifically for allergies to penicillin or venom, and should cost approximately $25 per allergen. Patch tests: CPT code 95044, are used to test for allergens that cause contact dermatitis and should cost approximately $10 per allergen. A blood test, CPT code 86003, should cost $5 to $20 per allergen and $200 to $1000 total without insurance. Consult your insurance provider and ask what the allowed charge is for a specific CPT code (4)