Access to Genetic Counselor Services Act of 2026
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
The Access to Genetic Counselor Services Act of 2026 amends the Social Security Act to add genetic counseling services as a covered benefit under Medicare Part B, effective January 1, 2027. It defines "genetic counselor" as someone licensed by their state or, in states without licensing, certified by the American Board of Genetic Counseling. Genetic counselors would be able to bill Medicare directly. Medicare would pay 80% of the lesser of the actual charge or 85% of the physician fee schedule rate. The bill preserves the ability of physicians and other providers to continue billing for genetic counseling they provide. The HHS Secretary may implement changes via interim final rule.
Who Benefits and How
- Genetic counselors: Gain recognition as Medicare providers with direct billing authority, expanding their professional autonomy and patient base.
- Medicare beneficiaries: Gain coverage for genetic counseling services, improving access to personalized medicine, risk assessment, and treatment planning.
- American Board of Genetic Counseling: Its certification becomes the qualifying credential in states without licensure.
- Patients in states without genetic counselor licensure: Still able to access covered services through board-certified counselors.
Who Bears the Burden and How
- Medicare trust fund / federal taxpayers: New covered service category increases Medicare spending.
- Genetic counselors: Reimbursed at only 85% of the physician fee schedule rate, creating a pay differential.
- Physicians currently providing genetic counseling: May face competition from genetic counselors who can now bill Medicare directly at lower rates.
Key Provisions
- Adds "covered genetic counseling services" to Medicare Part B benefits (Section 1861(s)(2))
- Defines genetic counselor: state-licensed, or ABGC-certified in non-licensing states
- Payment: 80% of lesser of actual charge or 85% of physician fee schedule
- Genetic counselors added to list of practitioners eligible for direct Medicare billing
- Effective date: January 1, 2027
- Savings clause: does not prevent other providers from billing for genetic counseling
- May be implemented by interim final rule
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Add genetic counseling services to Medicare Part B coverage, establishing genetic counselors as recognized Medicare providers who can bill directly at 85% of the physician fee schedule rate.
Key Policy Areas
Medicare, Healthcare, Genetics
Primary Purpose
Add genetic counseling services to Medicare Part B coverage, establishing genetic counselors as recognized Medicare providers who can bill directly at 85% of the physician fee schedule rate.
Policy Domains
Medicare Coverage of Genetic Counseling Services
Identified Gains
Contextual inference, no direct clause citation- Genetic counselors
- Medicare beneficiaries
- American Board of Genetic Counseling
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Medicare trust fund
- Physicians providing genetic counseling
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
In CommitteeMr. Barrasso (for himself, Mr. Welch, Mrs. Capito, and Ms. …
Read twice and referred to the Committee on Finance. (text: …
Introduced in Senate
Impact analysis is available but no clear stakeholder effects identified. View clause-level analysis →
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "Genetic counselors"
- → Gain direct Medicare billing authority
- "American Board of Genetic Counseling"
- → Certification serves as qualifying credential in non-licensing states
- "Secretary of Health and Human Services"
- → May implement by interim final rule, establishes additional criteria for non-licensed states
Key Definitions
Terms defined in this bill
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology