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H.R. 6280House119th Congress (2025-2027)In Committee

Access to Genetic Counselor Services Act of 2025

Sponsored by Adrian SmithRep. Adrian Smith (R-NE)
Introduced November 21, 2025

AI-Generated Summary

Updated December 17, 2025 at 9:26 AM UTC

The Access to Genetic Counselor Services Act of 2025 would expand Medicare Part B to cover services provided by genetic counselors. It defines what qualifies as covered genetic counseling and who can be considered a genetic counselor, then sets payment rules for those services. The changes affect Medicare beneficiaries who receive genetic counseling and the counselors who provide those services.

Key Provisions

  • Adds a new category of "covered genetic counseling services" to Medicare, effective Jan. 1, 2027.
  • Defines a "genetic counselor" as a state‑licensed counselor or, in states without licensure, a counselor certified by the American Board of Genetic Counseling and meeting HHS criteria.
  • Includes genetic counselors in balance‑billing protections for Medicare beneficiaries.
  • Sets Medicare payment for covered genetic counseling at 80% of the lesser of the actual charge or 85% of the physician fee‑schedule amount that would apply if a physician provided the service.
  • Updates related Medicare sections to reference covered genetic counseling services alongside other qualified services.
  • Clarifies that physicians and other providers may also bill for genetic counseling when it is otherwise covered.
  • Allows the HHS Secretary to implement the changes through an interim final rule with a comment period.

Legislative Activity

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HouseIntro Referral Latest Action

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Energy and Commerce Committee

November 21, 2025

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HouseIntro Referral

Introduced in House

November 21, 2025

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Energy and Commerce Committee

November 21, 2025

Bill Text

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Introduced in HouseIssued November 21, 2025

I

119th CONGRESS

1st Session

H. R. 6280

IN THE HOUSE OF REPRESENTATIVES

November 21, 2025

Mr. Smith of Nebraska (for himself and Ms. Castor of Florida) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act to provide for expanded coverage of services furnished by genetic counselors under part B of the Medicare program, and for other purposes.

1.

Short title

This Act may be cited as the Access to Genetic Counselor Services Act of 2025.

2.

Medicare coverage of genetic counseling services

(a)

In general

Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended—

(1)

in subsection (s)(2)—

(A)

by striking and at the end of subparagraph (II);

(B)

by adding and at the end of subparagraph (JJ); and

(C)

by adding at the end the following new subparagraph:

(KK)

covered genetic counseling services (as defined in subsection (nnn)(1));

; and

(2)

by adding at the end the following new subsection:

(nnn)

Covered Genetic Counseling Services

(1)

The term covered genetic counseling services means genetic counseling services furnished on or after January 1, 2027, by a genetic counselor (as defined in paragraph (2)) and such services and supplies furnished as an incident to the provision of such services which the genetic counselor is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) as would otherwise be covered if furnished by a physician (or as incident to a physician’s service).

(2)

The term genetic counselor means an individual who—

(A)

is licensed as a genetic counselor by the State in which the individual furnishes genetic counseling services; or

(B)

in the case of an individual practicing in a State that does not license genetic counselors, is certified by the American Board of Genetic Counseling and meets such other criteria as the Secretary establishes.

.

(b)

Balance billing

Section 1842(b)(18)(C) of the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by adding at the end the following new clause:

(ix)

A genetic counselor (as defined in section 1861(nnn)(2)).

.

(c)

Payment

Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended—

(1)

by striking and (HH) and inserting (HH); and

(2)

by inserting before the semicolon at the end the following: , and (II) with respect to covered genetic counseling services (as defined in section 1861(nnn)(1)), the amount paid shall be equal to 80 percent of the lesser of (i) the actual charge for the services or (ii) 85 percent of the fee schedule amount provided under section 1848 that would have applied had the genetic counseling services been furnished by a physician.

(d)

Conforming amendment

Section 1862(a)(14) of the Social Security Act (42 U.S.C. 1395(y)(a)(14)) is amended by inserting covered genetic counseling services, after qualified psychologist services,.

(e)

Rule of construction

The amendments made by this section shall not be construed as preventing physicians and health care providers other than genetic counselors from billing for genetic counseling services under the Medicare program which are otherwise covered under such program.

(f)

Implementation

Notwithstanding any other provision of law, the Secretary of Health and Human Services may implement the amendments made by this section by interim final rule with comment period.