How to Add Allergy Testing & Treatment to Your Practice

Written by Empire Medical Training Editorial Team

Medically reviewed by Sherry Wehner, MD Board-Certified Pathologist & Dermatopathologist; Aesthetic & Wellness Medicine

Updated June 2026 ·10 min read

When Dr. Sherry Wehner introduces this material, she frames it the way every clinician evaluating a new service line should: allergy testing and treatment brought additional revenue and patient satisfaction to her own practice, and it can do the same for yours. That ordering matters. The reason allergy care works as a practice addition is not that it is novel or trendy — it is that the demand already exists inside your patient panel, the science is well-established, and, unlike most of what gets added in aesthetic and wellness settings, it is reimbursable through insurance.

This page is the business-and-workflow companion to our clinical guides. It sits under the Allergy Testing & Treatment pillar and is written for clinicians deciding whether — and how — to bring testing and immunotherapy in-house. It is practice education, not medical advice, and it deliberately stops short of protocols, dosing schedules, and CPT-code lists, which are taught in Empire's course.

Why add allergy testing and treatment?

Start with the size of the opportunity. Allergies affect more than 56 million Americans. Approximately 30% of American adults have environmental allergies, and at least 10% have at least one food allergy. Allergy is the sixth leading cause of chronic disease in the United States. Despite that prevalence, the typical patient with chronic rhinitis, sinusitis, conjunctivitis, or eczema is managed with antihistamines and nasal sprays year after year and is never actually tested to learn what they are allergic to. That gap between how common allergy is and how rarely it is properly worked up is the underserved demand you are stepping into.

The second reason is the reimbursement profile. Much of what practices add today — many aesthetic and wellness services — is cash-pay. Allergy is different: skin-prick testing and specific-IgE blood testing are generally insurance-reimbursable, and subcutaneous immunotherapy is usually covered for patients who qualify. That changes the conversation with patients, who do not have to choose between their symptoms and an out-of-pocket bill, and it broadens the population that can realistically say yes.

Third, immunotherapy creates a recurring, multi-year clinical relationship that few added services match. As Wehner puts it, you can take a patient who has suffered for years from debilitating seasonal allergies, give them a year or two of allergy shots, and return them to a relatively normal life. That is a genuinely disease-modifying outcome — and it keeps patients engaged with your practice across dozens of visits.

Who it fits

You do not have to be a board-certified allergist to test patients and provide immunotherapy. A board certification in allergy and immunology exists, but it is not required to offer these services. What is required is proper training, an appropriate clinical setting, and emergency readiness. That makes allergy care a natural fit for several types of practice:

• Primary care. You already see the chronic rhinitis, sinusitis, asthma, and eczema patients. Testing converts symptom management you are already doing into a diagnosis and a treatment pathway.
• Aesthetic and wellness practices. Allergy testing complements an existing skin- and wellness-focused panel and gives an established cash-pay practice a reimbursable service line. This is the model Dr. Wehner runs in her own aesthetics and wellness practice.
• Functional and integrative medicine. Allergy and the immune response are squarely within a root-cause framework. For broader immune and inflammatory context, see the functional medicine resource.

What unites all three is that the candidates are patients you already have. You are not buying new patient acquisition; you are serving an unmet need in the panel in front of you.

The workflow: identify, test, treat

Operationally, adding allergy care comes down to three repeatable steps.

1. Identify candidates

Screen your existing patients for the conditions allergy commonly drives: chronic or recurrent rhinitis, sinusitis, conjunctivitis, eczema, urticaria, and allergic asthma. Genetics help you flag risk — a child with one allergic parent is 30–50% more likely to develop allergies, and 60–80% more likely with two. These are the patients to work up rather than continue to medicate indefinitely.

2. Test

The two first-line, insurance-covered tests are the skin-prick test and specific-IgE (RAST) blood testing. The skin-prick test is the everyday workhorse; the blood test is the alternative when skin testing is not appropriate, such as a patient with severe eczema or dermatographism or one who cannot stop interfering medications. Insurance generally covers a skin-prick panel once per year, which is why testing should be a complete, well-chosen panel the first time rather than a partial panel you revisit. Test results require clinical correlation — neither test is a stand-alone diagnosis, and the goal is to answer a clinical question, not to fish.

3. Treat

Patients who have at least three positive environmental allergens on skin testing generally qualify for insurance-covered subcutaneous immunotherapy — about one in five tested patients. Immunotherapy is the only disease-modifying allergy treatment and runs in two phases: a build-up phase with more frequent visits, then a maintenance phase. For the full picture, see allergy immunotherapy.

Understanding the immunotherapy options

Most of the treatment relationship runs on subcutaneous immunotherapy (SCIT) — conventional allergy shots — which is well-established for environmental allergens and usually covered by insurance for qualifying patients. It is worth being candid with patients about the alternatives so expectations are set honestly. Sublingual immunotherapy (SLIT) tablets are FDA-approved for specific allergens such as grass, ragweed, and dust mite and are growing in popularity; compounded sublingual “allergy drops” are largely off-label, generally less effective, and typically not covered by insurance. Note also that immunotherapy is for environmental allergens — it is not used to treat food allergy. The disease-modifying value, the coverage, and the multi-year relationship all live primarily on the SCIT side.

Staffing and the in-office allergy lab

Two things make this efficient rather than burdensome: a trained team member and a certified allergy lab. You do not have to mix your own immunoserums. Most physicians have a certified full-service allergy lab prepare their serums — Wehner strongly recommends working with one, at least when you start. A full-service lab supplies the administration materials, lends expertise in ordering the correct allergens, provides customizable immunological solutions, and offers a region-appropriate allergen panel, since what people react to in San Antonio differs from elsewhere in the country. The lab typically charges a flat fee per injection or test given.

Inside your office, a trained technician or nurse can perform the skin-prick test and administer immunotherapy injections under your supervision, which is what lets allergy care run alongside your existing schedule rather than consuming your day. The build-out of that in-office lab — equipment, antigen handling, the technician's role, and selecting a lab partner — is covered in depth in our companion guide on setting up an allergy lab and, in turnkey detail, in Empire's course.

Billing, coding, and reimbursement at a high level

This is where allergy care distinguishes itself, and where the discipline matters. The headline is simple: the core services are insurance-reimbursable. Skin-prick testing and specific-IgE blood testing are billable diagnostic services, immunoserum preparation is separately billable, and immunotherapy injections carry a higher reimbursement than testing — and, like the annual skin test, the treatment relationship recurs over the year.

A few principles drive the model without getting into code lists. Testing reimbursement reflects the number of antigens you test, so the panel is documented antigen by antigen. Insurance covers a skin-prick panel about once per year, so a partial panel followed by a second, fuller one will not both be paid — another reason to test thoroughly the first time. And every dollar of this depends on doing the paperwork, billing, and coding correctly; reimbursement follows clean documentation, not good intentions.

Deliberately, this page does not list CPT codes, units, or fee schedules. The exact codes for testing, for immunoserum preparation, and for immunotherapy administration — and how to document antigen counts and the once-yearly rules — are taught in Empire's course, where they can be presented accurately and kept current. Be appropriately skeptical of anyone promising specific income figures; results depend on your volume, your payer mix, and your billing accuracy. We do not publish income guarantees, and neither should you build a business case on one.

Realistic expectations and getting started

The honest framing is that allergy care is a strong addition because the fundamentals are sound, not because of any promised number. The demand is real and already in your practice. The services are reimbursable. The clinical outcomes — particularly with immunotherapy — are meaningful and durable. And the operational lift is manageable once you have a trained technician and a certified lab partner. What it asks of you is proper training, an emergency-ready setting, accurate billing, and the judgment to test and treat appropriately rather than over-test.

That training is the product. Empire's Allergy Test & Treatment course, taught by Dr. Sherry Wehner, walks through the entire model end to end: the science of allergic disease, skin and blood testing, immunotherapy, the in-office lab, and the billing and coding that make the service line work. If you are evaluating this for your practice, the course is the next step. You can also explore the related immunotherapy and skin-testing guides for the clinical detail behind the workflow.