The GeneDx Commitment: Working together to ensure that cost is not a barrier to genetic testing.

Our dedicated team of billing experts is available to answer patients’ questions so you can focus on providing the best care.

Billing Options

GeneDx accepts all commercial insurance, Medicare, and Medicaid, and Tricare and encourages prior authorization (PA) for all test orders. We can also bill your institution directly, offer self-pay pricing, and provide a Financial Assistance Program (FAP) for eligible patients. 

Commercial Insurance

We are in-network with many national and regional health plans. For a complete list of in-network plans, please refer to our In-Network Contract List.

Some commercial health insurance plans may require additional documentation to complete the prior authorization and/or billing process. You can access those forms here.

How to Help Ensure a Smooth Billing Process with Commercial Insurance

We encourage you to submit a prior authorization and supporting documentation up front with the test order. This clinical information can also help us uncover more actionable answers for your patients. Here are some common medical policy requirements used to determine coverage for whole exome sequencing (WES):

• Meeting disease-specific criteria, which include clinical and family features
• Completion of payer required prior authorization (PA) before testing
• Genetic counseling by a qualified entity other than the laboratory performing the testing, occurring both pre- and post-test
• Pre-test patient evaluation by a specific medical specialist, most commonly those with documented expertise (medical geneticist, neurologist, developmental pediatrician, neonatologist)
• Provider-completed documentation to support medical necessity

The above list is not exhaustive, and some items do not apply as payor criteria vary.