Major Insurers to Cover Higher Newborn Screening Fee

Thanks to the Texas Medical Association, six of the state's largest insurers have agreed to reimburse physicians for the new higher cost of newborn genetic screening. The Texas Department of State Health Services (DSHS) raised the fee from $19.50 to $29.50 per test on Nov. 1.

Aetna, Blue Cross and Blue Shield of Texas, CIGNA, Humana, Unicare, and United Healthcare, agreed to cover the higher cost after TMA contacted the companies about adjusting their fee schedules.   

To be reimbursed, physicians must use the HCPCS code S3620 - the Newborn Metabolic Screening Panel. It includes the test kit, postage, and the laboratory tests specified by the state.

For more information, e-mail the TMA Knowledge Center , or call (800) 880-7955, or (512) 370-1550.

In 2005, the Texas Legislature ordered newborn screening expanded, and DSHS decided to move to 27 tests recommended by the American College of Medical Geneticists and the March of Dimes. Expanded testing will begin in early 2007.



Last Updated On

July 14, 2010

Originally Published On

March 23, 2010