S. 3607 expands Medicare coverage to include genetic counseling services furnished by qualified genetic counselors, starting January 1, 2027. The bill defines eligible genetic counselors as those licensed by their state or, in states without licensing, certified by the American Board of Genetic Counseling. Medicare would cover 80 percent of genetic counseling services, calculated at 85 percent of the physician fee schedule rate, protecting patients from balance billing by genetic counselors. The legislation affects Medicare beneficiaries seeking genetic counseling and allows genetic counselors to be independently reimbursed providers, while also preserving the existing right of physicians and other healthcare providers to bill for genetic counseling services. No specific funding amount is mentioned in the bill, and the Secretary of Health and Human Services is authorized to implement the changes through expedited regulatory procedures.
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