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New Billing Code for Genetic Counselors Aims for Improved Reimbursement

Coding


New Billing Code for Genetic Counselors Aims for Improved Reimbursement

Date Posted: Tuesday, October 282, 2024

 

Genetic counselors are optimistic that a newly introduced billing code will enhance their ability to accurately bill for patient interactions and secure better reimbursement rates. This sentiment emerged during the recent annual meeting of the National Society of Genetic Counselors (NSGC).

 

A new Current Procedural Terminology (CPT) code for genetic counselors, 96041, aims to improve reimbursement by allowing genetic counselors to bill for the total time they spend with a patient on the day of an encounter:

 

Effective date The new code will go into effect on January 1, 2025.

 

Changes

The new code eliminates the face-to-face requirement of the previous code, 96040, and allows genetic counselors to bill for time spent outside of an appointment.

 

Benefits

The new code is expected to expand access to genetic counseling services and help genetic counselors reach more patients.

 

Efforts

The National Society of Genetic Counselors (NSGC) and the American College of Medical Genetics and Genomics (ACMG) led efforts to develop the new code. The need for a new code to better describe genetic counseling services was highlighted in a 2006 report by the Secretary's Advisory Committee on Genetics, Health, and Society.

 

 

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