Current Landscape of Insurance Reimbursement for Genetic Testing

Description
This presentation will summarize the current landscape of insurance coverage for genetic testing across diverse areas such as cardiology, oncology, neurology and
rare disease exome sequencing, pointing out commonalities and differences between major payors. It will also highlight specific “pain point” requirements for
some payors and provide tips for increasing the likelihood that your patient will obtain coverage.

Level of Instruction
Intermediate - Refresher course; some basic knowledge of subject recommended

Learning Objectives

1. Describe the current state of insurance coverage for genetic testing across multiple disease areas.
2. Highlight significant discrepancies in coverage among major payors.
3. Provide guidelines for ordering genetic testing that will maximize reimbursement for your patients.

Course summary

Available credit: 
  • 0.10 NSGC CEU
Course opens: 
10/01/2025
Course expires: 
10/01/2026
Cost:
$0.00

Presenter: Rob Pilarski, MS, LGC

Medical Affairs Director at Ambry Genetics

Robert Pilarski is Medical Affairs Director at Ambry Genetics, working on aligning payer policies and national genetic testing guidelines and overseeing medical necessity review processes. Prior to this he was a licensed and board-certified genetic counselor and Professor of Clinical Internal Medicine at the Wexner Medical Center and James Comprehensive Cancer Center at The Ohio State University. He has over 90 publications in medical and scientific journals. He has presented regularly at national and regional conferences and has served as an ad hoc review for numerous medical and genetics journals. Mr. Pilarski was a past board member of the National Society of Genetic Counselors, and co-founder and past president of its Cancer Genetics Special Interest Group. Until joining Ambry Genetics he was the vice-chair of the National Comprehensive Cancer Network’s guidelines panel on Genetic/Familial High-Risk Assessment: Breast and Ovarian Cancers, which set testing and management guidelines for individuals at risk for hereditary breast and ovarian cancers.

 

Moderator: Anusha Klinder, MS, CGC

Genomic Science Liaison at Ambry Genetics

Anusha Klinder is a certified genetic counselor and genomic science liaison specializing in cardiology, neurology, and pulmonology for the western U.S. territory. She obtained her Bachelor of Science in Global Disease Biology with a minor in Education from UC Davis and her Master of Science in Genetic Counseling from UC Irvine's College of Medicine. Prior to joining Ambry Genetics, she built out a genetic counseling role for adult cardiothoracic surgery inpatients and outpatients at Stanford's Center for Inherited Cardiovascular Disease. In both personal and professional spaces, she is passionate about precision medicine and strives to make healthcare more accessible and equitable, especially within cardio and rare disease communities.


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Ambry Genetics is approved as a provider for continuing education program by NSGC and ASCLS P.A.C.E ® Programs.

Credit eligibility varies by activity; please see below for the specific credit types offered for this course.

Available Credit

  • 0.10 NSGC CEU

Price

Cost:
$0.00
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