,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #cbce  ,,in ,,the ,,house ,,of  
,,representatives  ,june #ab1 #bjai,mr4 
,loebsack 7for himself and ,mr4 ,kelly  
of ,pennsylvania7 introduced the        
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committee on   
,ways and ,means1 for a period to be    
subsequently determined by the ,speaker1
 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 program1 and   
for other purposes4  #a4 ,short title   
,this ,act may be cited as the ,access  
to ,genetic ,counselor ,services ,act of
 #bjai4  #b4 ,medicare coverage of      
genetic counseling services  7a7 ,in    
general ,section #ahfa of the ,social   
,security ,act 7#db ,u4,s4,c4 #aciex7 is

 amended--  7#a7 in subsection 7s77#b7--
 7,a7 by striking and at the end of     
subparagraph 7,,gg72  7,b7 by adding and
 at the end of subparagraph 7,,hh72 and 
7,c7 by adding at the end the following 
new subparagraph3  7,,ii7 covered       
genetic counseling services 7as defined 
in subsection 7kkk77#a772  2 and  7#b7  
by adding at the end the following new  
subsection3  7kkk7 ,covered genetic     
counseling services  7#a7 ,the term     
covered genetic counseling services     
means genetic counseling services       
furnished by a genetic counselor 7as    
defined in paragraph 7#b77 7and such    
services and supplies furnished as an   
incident to the provision of such       
services7 as would otherwise be covered 
under this title if furnished by a      
physician 7or as incident to a          
physician's service74  7#b7 ,the term   
genetic counselor means an individual   
who-- 7,a7 is licensed as a genetic     
counselor by the ,state in which the    
individual furnishes genetic counseling 

services2 or  7,b7 in the case of an    
individual practicing in a ,state that  
does not license genetic counselors1    
meets such other criteria as the        
,secretary establishes4  ,the provisions
 of this paragraph shall not be         
construed as preventing other           
practitioners1 including those providing
 telehealth services1 from providing    
covered genetic counseling services     
within the scope of their practice4  4  
7b7 ,physicians' services ,section      
#ahdh7;j77#c7 of the ,social ,security  
,act 7#db ,u4,s4,c4 #aciew-#d7;j77#c77  
is amended by inserting 7#b77;,,ii71    
after 7#b77;,,ff7 7including            
administration of the health risk       
assessment7 14  7c7 ,payment  7#a7 ,in  
general ,section #ahcc7;a77#a7 of the   
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7a77#a77 is amended--  7,a7 by    
striking and 7,,cc7 and inserting       
7,,cc72 and  7,b7 by inserting before   
the semicolon at the end the following3 
1 and 7,,dd7 with respect to covered    

genetic counseling services under       
section #ahfa7s77#b77;,,ii71 furnished  
by a genetic counselor1 the amount of   
payment for such service shall be an    
amount equal to #he percent of the      
lesser of the actual charge for the     
services or the amount determined under 
the fee schedule established under      
section #ahdh7;b7 for the same services 
if furnished by a physician4  7#b7      
,modifier ,section #ahcd of the ,social 
,security ,act 7#db ,u4,s4,c4 #aciem7 is
 amended by adding at the end the       
following new subsection3  7x7 ,use of  
modifier with respect to genetic        
counseling services  7#a7 ,establishment
 ,not later than ,january #a1 #bjbj1 the
 ,secretary shall establish a modifier  
to be utilized with evaluation and      
management ,,cpt codes to indicate 7in a
 form and manner specified by the       
,secretary71 in the case of covered     
genetic counseling services under       
section #ahfa7s77#b77;,,ii71 if such    
services were furnished by a genetic    

counselor4  7#b7 ,required use ,each    
request for payment1 or bill submitted  
using evaluation and management ,,cpt   
codes1 for covered genetic counseling   
services 7as defined in section         
#ahfa7kkk77#a77 furnished by a genetic  
counselor 7as defined in section        
#ahfa7kkk77#b77 on or after ,january #a1
 #bjbj1 shall include the modifier      
established under subparagraph 7,a7 for 
each such service4  4  7d7 ,assignment  
of payment ,section #ahcc7r7 of the     
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7r77 is amended by adding at the  
end the following new paragraph3  7#c7  
,application to genetic counselors ,the 
provisions of paragraphs 7#a7 and 7#b7  
shall apply with respect to covered     
genetic counseling services described in
 section #ahfa7s77#b77;,,ii7 and genetic
 counselors 7as defined in section      
#ahfa7kkk77#b77 in the same manner as   
such provisions apply with respect to   
services described in section           
#ahfa7s77#b77,k77ii7 and nurse          

practitioners4  4  7e7 ,conforming      
amendment ,section #ahfb7;a77#ad7 of the
 ,social ,security ,act 7#db ,u4,s4,c4  
#acie7y77a77#ad77 is amended by         
inserting covered genetic counseling    
services1 after qualified psychologist  
services14  7f7 ,effective date  7#a7   
,in general ,the amendments made by this
 section shall apply to services        
furnished on or after ,january #a1      
#bjbj4  7#b7 ,implementation ,the       
,secretary of ,health and ,human        
,services may implement the amendments  
made by this section by interim final   
rule with comment period4