Medicare Benefits Schedule - Item 73454

Whole gene sequencing of a gene or genes described in item 73453, in a patient who is the reproductive partner of an individual who is affected by, or is a known genetic carrier of, one or more conditions described in item 73453 (other than cystic fibrosis, fragile‑X syndrome or spinal muscular atrophy), for the purpose of determining the couple’s combined reproductive risk of the conditions, if:

(a) the patient is not eligible for a service to which item 73453 applies; and

(b) the patient has not received a service to which item 73453 applies; and

(c) the patient has not received a service to which this item applies for the purpose of determining the patient’s reproductive risk with the patient’s current reproductive partner

Applicable once per couple per lifetime

Fee: $1,200.00 Benefit: 75% = $900.00 85% = $1,101.30

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