Should I Add Allergy Services to the Practice?

ENT practices see patients for issues with a host of conditions, ranging from ear infections to dysphagia.  Some patients also seek help for conditions that are related to allergies. When ENT physicians diagnose allergies that affect the ears, nose and throat, they often refer patients to other practices to manage symptoms and offer treatment. At that point, there’s a good chance that they’ll lose those patients to the new practice. If this sounds familiar, it may be time for you to consider opening an allergy department at your practice. This Ask Fuel First section answers the question: Should I add allergy services to my ENT practice?

Imagine a scenario where your practice offers comprehensive allergy care in-house, eliminating the need to refer patients elsewhere and increasing patient retention. Patients would first consult an ENT physician for diagnosis and treatment planning. Under the physician’s supervision, allergy technicians would streamline patient care by conducting allergy testing, administering injections, providing education, managing records and more. This setup ensures that patients can conveniently return to the ENT physician for follow-up care or for any other conditions that may arise.

Enhancing Your Patients’ Experience

Opening your own allergy department isn’t just about expanding your services. It’s about enhancing the quality of care you provide. With a collaborative approach between your physicians and allergy technicians, you can ensure greater accuracy of treatment and improved outcomes, even for the most complex cases. This seamless coordination also ensures that information is shared easily among the health care professionals at your practice, delivering high-quality, patient-centered care and building trust with your patients.  

Creating an allergy department at your practice is a considerate move for your patients. It offers them the convenience of receiving care in a single location, eliminating the need for lengthy waiting times for appointments through referrals. This can differentiate your practice from others that don’t have an allergy department, attract new patients and expand the services provided to your current patient base. It can also bring in new revenue.

Added Revenue

Beyond improving the patient experience, you may wonder how adding an allergy department to your practice can impact your revenue. Although we can’t tell you that an allergy department will be successful at your practice, we can tell you that it has been a success for other practices. Below is some basic financial data for a small ENT practice.

If we look at allergy CPT (current procedural terminology) codes used when billing Medicare in 2023, on average, practices charged the following rates for common allergy procedures:

  • 95165 (mixing) $14.65
  • 95115 (giving one shot) $10.32
  • 95117 (giving more than one shot) $12.32 (two-thirds of patients have more than one vial)
  • 95024 (intradermal allergy test or IDT) $7.99
  • 95004 (skin prick) $3.66

We know that Medicare rates vary based on region and other factors, so the amounts listed above are averages. We also assume that there’s a 50/50 split between Medicare and third-party payers, where third-party payers may pay 110% to 150% of the Medicare billing averages for the codes listed above. If your practice contracts more with third-party payers or your patients pay higher out-of-pocket rates, these numbers could be increased.

In 2023, on average, in small ENT practices, the number of procedures was as follows:

  • Conducted 206 allergy tests
  • Mixed 964 vials for current patients
  • Mixed 67 vials for new patients
  • Gave 5,431 total injections

That means that a small ENT practice may generate as much as $300,000 in revenue in the first year of opening an allergy department. Of course, there are some costs associated that you need to consider, such as the following:

  • $36,000 for cost of goods (such as needles, vials, printer labels, etc.)
  • $60,000 for salary of your allergy technician
  • $4,188 for software

Roughly, that’s $100,000 to run your new department. Unfortunately, we can’t calculate equipment costs or how much renting the extra space may cost you, as these elements vary greatly among practices. If you currently have enough space in your location and/or own the building, you’ll have an advantage over others just starting out.

Overall, a small ENT practice may make as much as $200,000 in its first year of opening an allergy department. As the practice gains new patients drawn in by the allergy services, revenue will continue to grow. This growth may be seen in ENT services, too, as new patients require other services from your practice. For medium to large practices, these estimates are compounded year after year.


Opening your own allergy department has benefits, such as streamlining patient care and adding revenue, but there are also some considerations, such as space, staff training and marketing. Here are some questions that you should ask yourself when considering a new allergy department:

  • Do I have enough space? Besides treatment rooms, you’ll need areas for testing equipment.
  • Do you have enough staff? You may need additional staff to run the allergy department, including allergy technicians and a front office specialist. Existing staff may suffice, but it’s definitely something to consider. Fuel Medical’s recruiting team can help you find the right people to fill your new positions.
  • Do you have the capacity to train staff? Staff for the allergy department will need to be trained on best practices and procedures for allergy testing and antigen injections, allergy-specific terminology and how to use allergy-related software for tracking. Fuel Medical can guide you through the process.
  • How will you develop a marketing strategy to raise awareness of your new services? You’ll need to let new and existing patients know about your new allergy department as well as what services you’ll provide. Fuel Medical’s marketing and regional teams can work with you to develop a marketing strategy.
  • Do you have the resources available to start an allergy department? The costs associated with new equipment, hiring additional employees, rearranging or adding new spaces and marketing should be factored into your decision. Your regional team and Fuel Medical’s leadership team can suggest some ways to pay for these associated costs, such as using manufacturer promotions, rebates and loan programs.

Safety Protocols

Determining how to manage safety protocols in your own allergy department is one more consideration. We know that safety is as important to you as it is to us at Fuel Medical. Our allergy team has guided practices through the process of opening an allergy department, being conscious of industry regulations and knowing the best practices for mixing antigens (see our Ask Fuel First article “Understanding How USP 797 Affects Your Practice’s Allergy Department”) and having the ability to walk you through what an effective workflow looks like. Our cloud-based software, Allergy EDGE™, is an integral part of developing safety protocols.

Allergy EDGE helps ENT practices nationwide with the following:

  • Reduce errors: A barcode system is used for tracking allergens and patient information, which minimizes errors often associated with manual record-keeping. This system also helps ensure that the right allergens and diluents are mixed for each patient.
  • Standardized procedures: Allergy EDGE has built-in protocols and checklists to guide staff through allergy testing procedures, ensuring consistency and reducing the risk of missed steps that could compromise safety.
  • Track vial expiration dates: Mixed vials are automatically tracked through Allergy EDGE. Allergy technicians can see if a vial is ready to be administered, nearing an expiration date or expired. Expired vials can increase the ineffectiveness of treatment, trigger adverse reactions and result in legal action against the practice, which is why regulatory agencies have established guidelines outlining the life of allergenic mixtures.
  • Detailed records: This software is a comprehensive tool for documenting patient information, test results and reactions, which is required by the USP and backed by the U.S. federal government.
  • Reduced wait times: The longer patients spend in waiting rooms, the more exposure to allergens or illnesses from other patients. Allergy EDGE features FastPass, which enhances the efficiency of patient check-in and tracks wait times after injections.

Next Steps

Opening an allergy department at your practice may seem overwhelming, but the benefits outweigh the challenges. As collaboration among providers improves, your patients will have a better experience. This includes having a variety of services offered in one location. You may also increase your patient base and revenue with this addition. Fuel Medical is here to help as you take the next steps. Your regional team will coordinate with our allergy experts to ensure you follow best practices in your journey to opening a new allergy department.

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