I 
119TH CONGRESS 
1ST SESSION H. R. 6280 
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. 
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 com-
mittee 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Access to Genetic 
Counselor Services Act of 2025’’. 
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SEC. 2. MEDICARE COVERAGE OF GENETIC COUNSELING 
SERVICES. 
(a) IN GENERAL.—Section 1861 of the Social Secu-
rity Act (42 U.S.C. 1395x) is amended— 
(1) in subsection (s)(2)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (II); 
(B) by adding ‘‘and’’ at the end of sub-
paragraph (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 sub-
section: 
‘‘Covered Genetic Counseling Services 
‘‘(nnn)(1) The term ‘covered genetic counseling serv-
ices’ 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). 
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‘‘(2) The term ‘genetic counselor’ means an indi-
vidual who— 
‘‘(A) is licensed as a genetic counselor by the 
State in which the individual furnishes genetic coun-
seling 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 Coun-
seling 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 Se-
curity 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 ge-
netic 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 
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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 serv-
ices,’’. 
(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. 
Æ 
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