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Genetic Services


Genetics is the branch of medicine that looks at how hereditary and genetic factors play a role in causing a disease, birth defect, or inherited susceptibility to a health problem such as cancer or heart disease. Information regarding Genetic Services can be found on the Department of State Health Services website.

Methodology / Rules

The Genetic Services program rules are located at Title 25 of the Texas Administrative Code, Part 1, Chapter 56, Rule 56.18.

Reimbursement rules applicable to Genetic Services are the same as those for Physician Services and are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 5, Rule 8085.

The fee schedules and any periodic adjustment(s) to the fee schedules are published in banner messages contained in provider Remittance and Status (R&S) reports, Medicaid Bulletin articles, web postings, provider manual, fee schedules or other provider notification.

Payment Rates

Payment rate information is published by procedure code in the applicable Texas Medicaid Fee Schedule located on the Texas Medicaid & Healthcare Partnership (TMHP) website (see Fee Schedules).