Genetic counseling is typically covered by medical insurance. However, it is important to check with your insurance company to find out about your specific coverage and whether you will need a referral. You can ask your insurance provider if they cover the CPT billing code for genetic counseling, which is 96040. For a telemedicine visit, the CPT code is 96040-GT. If you are seeking preauthorization, please ask for six units (three hours total) to ensure coverage for follow-up visits.
Medical insurance will also cover the costs of genetic testing when it is medically warranted and recommended by a physician or other health care provider. However, insurance companies have different policies about which tests are covered and by how much. Some insurers have specific requirements about what indications or reasons for testing qualify for coverage. To keep the cost to families as low as possible, we prefer to use genetic testing labs that will check your insurance coverage prior to running the test, alert you to any significant out-of-pocket costs and allow you to cancel the test if you decide the expected cost is too high.