There is so much to be grateful for this month, I don’t know where to begin. I am grateful that NSGC had so many excellent RFP proposals and firms interested in working with us to advance genetic counseling and improve patient access to genetic counselors. 

In addition, I am very grateful to everyone who attended the NSGC Annual Conference both in-person and virtually last month. It was my honor to deliver the NSGC President’s State of Society address during the Annual Conference. If you have not yet had an opportunity to watch the State of the Society, I encourage you to do so.  It has been a busy year and the recording has much more detail than I can cover in this column. During the address I discussed what NSGC has been working on to wrap up our 2022-2024 Strategic Plan, and I introduced the 2025-2027 Strategic Plan. The Board has finalized the overarching goals and objectives of the new plan and is working to finalize the tactics and key results  that we will use to meet our goals. The overarching goals of the new strategic plan are;

Over the next few months, I will introduce each of the three goals of the new plan. I want to start with the goal of “Achieve competitive reimbursement for genetic counselors to improve patient access.” I like to think of this goal as “get genetic counselors paid.” This goal has four main objectives, or pillars to support the sustainability of our profession and improve patient access to our services.  

 

The first objective is to Achieve federal recognition and Medicare reimbursement for genetic counseling services performed by genetic counselors. As mentioned above, the Board has selected the lobbying firm, Faegre Drinker to assist us with this objective.

The second objective is to engage and educate private payers and genetic counselors about our new CPT code to improve reimbursement of genetic counseling. As you may have seen, in January 2025, there will be a new genetic counselor CPT(R) code, 96041. What is exciting about the new code is that it can be billed for “total time provided by the genetic counselor on the date of the encounter, not just the face-to-face time covered by our old code. 

We believe the new code will expand access and help genetic counselors reach more patients by improving genetic counselor reimbursement. NSGC will coordinate outreach to major national payers and provide resources to help members and their institutions engage with local and regional payers as this shift occurs. I would like to take this opportunity to express my gratitude to the CPT Team: our volunteers, consultants and staff who worked incredibly hard through a long and challenging process to make the new code a reality! Thank you to all of the NSGC volunteers, staff, consultants, and our partners at ACMG who were wonderful collaborators throughout the process.  

NSGC will be providing education to our members on a rolling basis with some materials available beginning this month.  The plenary session on the new code that was presented at the Annual Conference in September is now available on our website so that anyone can learn how the new code affects a genetic counselor’s practice, and about the resources and support that will be available for you. 

The third objective is to increase state-level recognition via licensure and Medicaid reimbursement for genetic counseling services performed by genetic counselors. This summer, NSGC engaged Manatt Health, a national legal and consulting practice with deep analytic capabilities to assist health care professions and professionals in implementing their strategic and business goals, to complete a landscape analysis of Medicaid coverage for genetic counseling across the country. We are reviewing the results of this assessment and are determining how we can best share the data with our members.  We are also preparing to embark on a campaign to educate state Medicaid directors about our new CPT code and advocate for improved Medicaid coverage of genetic counselors.

The fourth objective is to educate and engage you, our members, in advocating for the sustainability of our profession and improved patient access to our services. While NSGC has already contacted national payers, there are many local and regional payers and employers who will need to be educated about our new CPT(R) code. It became apparent during our interviews with the various lobbying firms, and in our initial discussions with Faegre Drinker, that there will be an increasing number of ways that employers, organizations, and genetic counselors will be able to help advocate for Medicare recognition of genetic counselors. If you are interested in helping NSGC advocate for enhanced coverage of genetic counseling and improve patient access to our services, please complete this survey where you can indicate which one or more of the four pillars you are interested in becoming involved with. 

I look forward to working with you on improving genetic counselor reimbursement so we can get genetic counselors paid! I am also excited to continue to update you on our 2025-2027 Strategic Plan over the next few months.

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