Medicare recognizes that pharmacogenomic testing is an important part of mental health treatment and has a coverage policy in place. In this coverage policy, there are specific medical necessity requirements that your provider must note for this test to be covered. Myriad Neuroscience will work with your provider to collect this information and submit the claim for payment.
If the test is considered non-covered, your clinician will need to submit an Advanced Beneficiary Notice signed by you before we can deliver the GeneSight® test. By signing the ABN, you agree to pay the full cost of the test and will be billed accordingly. Learn more about ABN’s here.
Medicare (Part B) Covered Tests — You will have a $0 out of pocket cost.
Medicare Advantage Covered Tests — You may be expected to pay a portion of the cost (typically $330 or less) and the GeneSight Promise applies.
If your cost is $100 or more, we offer an interest-free payment plan that allows you to spread your payments over multiple months.
Billing any insurance provider takes time. The process may be lengthy; here is what to expect and when.
We receive your sample. When we receive your sample, we will confirm your cost. If it’s more than $330, we will call you before processing your test.
We bill your insurance. We process your test and submit a claim to your insurance company.
You may receive an explanation of benefits (EOB). Your insurance company will process your claim. They may send you an EOB. This is not a bill.
You receive your bill. Once your insurance claim is completed, we will send you a statement of what you owe. This is a bill. You can pay on-line, by phone, or by mail.