MedicaidBilling CodesMedium impact
Reimbursement for Genetic Counseling Services Rendered by Genetic Counselors
Illinois Medicaid - HFS·IL · Genetics, OB-GYN, Oncology·Provider Notice
Effective date
Oct 1, 2008
We identified it
Jun 21, 2026
Summary
Physicians can now bill for genetic counseling services provided by licensed genetic counselors using CPT code 96040 at $40.20 per session. New BRCA genetic testing procedure codes (S3818, S3819, S3820, S3820QP, S3822, S3823) are also available for billing.
Action Required
Immediately: Billing team must add CPT code 96040 to billing system with reimbursement rate of $40.20 for genetic counseling services. Add new BRCA genetic testing codes S3818, S3819, S3820, S3820QP, S3822, S3823 to system. Update encounter forms to include these codes. Ensure physicians document when genetic counselor provides services to support billing under physician's name per Illinois Genetic Counselor Licensing Act requirements.