Journal of Genetic Counseling

, Volume 19, Issue 1, pp 38–43

Billing for Medical Genetics and Genetic Counseling Services: A National Survey

  • Tabitha A. Harrison
  • Debra Lochner Doyle
  • Caroline McGowan
  • Leslie Cohen
  • Elizabeth Repass
  • Ruthann B. Pfau
  • Trish Brown
Original Research

DOI: 10.1007/s10897-009-9249-5

Cite this article as:
Harrison, T.A., Doyle, D.L., McGowan, C. et al. J Genet Counsel (2010) 19: 38. doi:10.1007/s10897-009-9249-5

Abstract

In January 2007 the American Medical Association added a new Current Procedural Terminology® (CPT) code, 96040, for “Medical Genetics and Genetic Counseling Services.” In order to identify the impact of having this new code and to identify issues with implementation of the code, the National Society of Genetic Counselors (NSGC) CPT® Working Group surveyed NSGC members using an internet-based survey tool. The majority of respondents (94%) reported being aware of the new code and over half of the respondents (69%) said they were billing for genetic counseling. Approximately 24% of those billing reported using 96040. Many facilities are not using this code and the reported success of billing using 96040 is highly varied. Continued education may be beneficial to encourage reimbursement for 96040 and follow up is needed to assess the ongoing implementation and impact of the new CPT® code.

Keywords

Genetic counselor Reimbursement Billing CPT® code 

Copyright information

© National Society of Genetic Counselors, Inc. 2009

Authors and Affiliations

  • Tabitha A. Harrison
    • 1
  • Debra Lochner Doyle
    • 1
    • 2
  • Caroline McGowan
    • 2
  • Leslie Cohen
    • 2
  • Elizabeth Repass
    • 2
  • Ruthann B. Pfau
    • 2
  • Trish Brown
    • 2
  1. 1.Genetic Services Section, Washington State Department of HealthKentUSA
  2. 2.National Society of Genetic Counselors, CPT® Working GroupChicagoUSA

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