Billing

Commercial Insurance Billing Policy

GeneDx does not participate in any insurance plans at this time and will be billing as an “out-of-network” service provider. To bill insurance, a photocopy of the front and back of the patient's insurance card must accompany the patient sample.

Test Insurance Billing policy Patient responsibility Credit card guarantee

Tests on Cardiology, Neurology, and Prenatal Requisition Forms

– All commercial insurance accepted

– Medicare not accepted

– Medicaid not accepted

GeneDx will bill and carry out appeals as necessary Co-pay, co-insurance and unmet deductible* Not required except for the following: All Blue Cross, Blue Shield and related plans, GHI, Healthnet, State Health Plan of North Carolina, and Teamsters Benefits Trust
Exome Sequencing (XomeDx)

– Most commercial insurance can
be billed

– Medicare not accepted

– Medicaid not accepted

– Tricare not accepted

– California and Maryland HMO
plans not accepted

GeneDx will bill and carry out appeals as necessary $1000 per trio Required
All other tests**

– Most commercial insurance can
be billed

– Medicare not accepted

– Medicaid not accepted

– Tricare not accepted

– California and Maryland HMO
plans not accepted

GeneDx will courtesy bill the insurance company Unpaid Balance Required

* Waiver or reduction of co-pay, co-insurance and unmet deductible will be determined based on patient’s financial need.

** GeneDx requires a written letter of pre-authorization in order to bill insurance for these tests. This letter should state that the request for genetic testing for the specific disease/gene has been approved. It is most helpful if the level of reimbursement is also included in the letter. In most cases, an authorization number alone will not be acceptable.
 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheet
 

 

 

A printable Price List for all GeneDx tests (without CPT codes) is also available.

2012 AMA CPT Codes

 

Financial Policy for Institutional Billing

 

  • GeneDx can directly bill a referring institution. To establish an account with us enter your billing information in section one of our payment option form and an account will be automatically established for the institution. If your facility requires a PO Number be used also enter the number on the payment option sheet at the time initial sample is received. This works very well for hospitals/institutions with clinical laboratories and those that have a Send-Out or Referral department. If you have any questions call GeneDx Accounts at 301-519-2100, ext 6106.

 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheett
 

 

 

A printable Price List for all GeneDx tests (without CPT codes) is also available.

2012 AMA CPT Codes

 

Financial Policy for International Patients

 

  • Patient Pay: Samples from outside the United States must be accompanied by full payment at the time of sample submission when being paid by patient/family. Payment by check or credit card must be included with sample when patient is paying. If paying by wire transfer, payment must be received before sample arrives or shortly thereafter. A $30 wire transfer fee must be added to cost of test when paying by wire transfer. Payment must be in $US Dollars.
  • Institution Billing: We are able to invoice institutions that are outside of the United States. Payment can be by check, credit card or wire transfer. $30 wire transfer fee must be added to cost of test when paying by wire transfer. Payment must be in $US Dollars.
  • We do not bill international insurance companies.
  • To obtain information for wire transfer, please contact GeneDx by e-mail (genedx@genedx.com) or phone, 301-519-2100.

 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheet

 

 

A printable Price List for all GeneDx tests (without CPT codes) is also available.

2012 AMA CPT Codes

 

Prepayment at the time of sample submission can be achieved by:

 

  • Check or money order, payable to GeneDx, Inc. for the quoted full cost of the test
  • Check or money order, payable to GeneDx, Inc. for 75% of the quoted cost of the test. The remainder will be billed at completion of the test prior to reporting of results.
  • Charge to Visa, Mastercard, Discover, or American Express for the full quoted cost of the test at the time of sample submission. Credit card payments will not be split.

 

Prices and CPT Codes

Select one of the following links on the Tests Offered menu and open the document indicated:

Document

Select the gene, then open Information Sheet
Select the disease, then open Information Sheet
Select the test, then open Information Sheet
Open Information Sheet
Open Information Sheet

 

 

A printable Price List for all GeneDx tests (without CPT codes) is also available.

2012 AMA CPT Codes