Medicare Benefits Schedule - Item 73426

Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if:

(a) the service is requested:

(i) by a specialist or consultant physician; and

(ii) for a suspected genetic neuromuscular disorder; and

(iii) after exclusion of non‑genetic causes; and

(b) the request states that singleton testing is inappropriate; and

(c) the service is performed using a sample from the fetus and a sample from each of the fetus’s biological parents; and

(d) the service is not performed in conjunction with a service to which item 73425 applies

Applicable once per pregnancy

Fee: $2,400.00 Benefit: 75% = $1,800.00 85% = $2,301.30

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