Frequently asked questions.

No. You can schedule directly without a referral from your doctor.* If your physician did refer you, that's fine too — you don't need any paperwork from them to book. Note that if genetic testing is recommended during your appointment, involving your physician in the ordering process may be advantageous for insurance coverage purposes, regardless of your state.

* One exception is for residents of SD. SD law requires a physician referral to see a genetic counselor.

No. Grey Genetics is self-pay only. We don't bill insurance for our services, so your genetic counseling appointment stays off your insurance record. We accept all major credit cards and HSA.

We can provide a superbill upon request if you'd like to submit for possible out-of-network reimbursement. Reimbursement for genetic counseling varies widely by plan — some insurers do reimburse using CPT code 96041, but coverage is not consistent across plans and we cannot guarantee reimbursement. If you plan to submit, it's worth checking with your insurer in advance.

If genetic testing is recommended, we'll discuss your options — including whether to pursue insurance coverage for testing, which is a separate decision you control. Genetic testing is often covered by insurance even when the counseling visit itself is not.

Note: Medicare does not currently reimburse for genetic counseling services provided by certified genetic counselors, because genetic counselors are not yet recognized as Medicare providers under federal law. Bipartisan legislation to change this has been introduced in Congress multiple times. The Access to Genetic Counselor Services Act (H.R. 6280/S.3607) would finally recognize genetic counselors as Medicare providers, potentially expanding care to seniors, improving quality of care, and reducing overall healthcare costs. Use this form (for patients) or this form (for clinicians) to contact your representatives and voice your support.

Appointment fees are listed on the scheduling page.

Grey Genetics offers a limited number of sliding-scale appointments for patients with a clear medical indication for genetic counseling and documented financial hardship. Sliding-scale fees are guided by HHS Poverty Guidelines. Documentation (such as a recent tax return) is required and can be submitted by secure email. To inquire, email info@greygenetics.com.

Genetic counseling and genetic testing are two separate services with separate costs. The appointment you book with Grey Genetics is the genetic counseling visit. Any genetic testing coordinated following your appointment is billed directly by the laboratory and is not included in your appointment fee.

Genetic testing costs vary widely by test, laboratory, and other factors, including possible insurance coverage and laboratory self-pay pricing. A meaningful answer often requires knowing your personal and family health history, your goals for testing, and your insurance situation. This is all discussed as part of a genetic counseling appointment.

Researching testing options and costs is part of what genetic counselors do. This often involves reaching out to laboratories directly to compare testing options and pricing, and may include identifying financial hardship programs for patients who qualify.

We see patients anywhere in the U.S. and internationally. If you are located in a state with a genetic counselor licensure law, you will need to be seen by a genetic counselor who holds a license in your state. The states in which each genetic counselor is licensed to see patients are indicated on their profile — and the scheduling widget handles this filtering automatically. For patients outside the 50 U.S. states and D.C., we may have limitations around facilitating genetic test orders — your counselor will discuss options during your appointment.

Yes! Some of the genetic counselors listed on the Network speak languages other than English, including Spanish and French. Languages are noted on each genetic counselor's profile page.

Using an interpreter who will join the Google Meet is also an option. This does incur additional costs and Grey Genetics passes on these costs to patients, without markup. At the time of writing, the rate was $1.49/minute for video interpretation for all languages aside from ASL, for which the cost is $1.95/minute. Google Meet does also include an automated Closed Captions (CC) option. (There is no cost for CC.)

Scheduling out several days can be helpful in making sure that an interpreter will be able to join the Google Meet at the scheduled time. On demand interpretation, however, is also possible. If you do require an interpreter, please indicate this when you schedule but also send us an email to confirm current pricing: scheduling@greygenetics.com

Gather information about your family health history. It's helpful to know specific diagnoses and ages at diagnosis. No one has perfect knowledge of their family health history — diagnoses from past generations or those made in other countries are often hard to confirm. Even knowing what is not known and cannot be found out is helpful.

If you or someone in your family had genetic testing done, provide a copy of the results in advance of your appointment. You will have an option to upload test results when booking. You can also send records through our secure email link.

Initial appointments are 60 minutes by video (or phone if preferred). Your genetic counselor will conduct a thorough review of your personal and family health history, discuss your risks and options and, when relevant, provide testing guidance and coordination. After your appointment, you'll receive a written consult note and pedigree by secure email, outlining recommendations, any testing ordered, and next steps.

It's a no-commitment conversation to help you figure out if and how genetic counseling could be helpful to you and which appointment type to book. No risk assessment or testing guidance is provided on these calls. This is very helpful for some situations. In others, it may make more sense to just go ahead and schedule an appointment.

Of course. Depending on the reason for your appointment, including family members is often ideal. Being able to include multiple family members in a genetics appointment — even if you live far apart from one another — is one of the key advantages of telehealth. If you're joining by video but want to include a family member who can only join by phone, they will be able to use the Google Meet call-in number. If you would like to involve a family member who would need to receive a call, your genetic counselor can also call them from within the Google Meet, after you've joined the call.

With your explicit permission, we are happy to discuss your case with your healthcare provider. We ask that you first share with them a copy of your consult note which will include the email address of the genetic counselor you saw. Then, if your healthcare provider has questions, they can reach out by email. Your genetic counselor will reply to secure email and/or coordinate a time to briefly speak. We will not call your doctor's office directly. If you've spent time calling doctors' offices, you probably know why.

If you live in one of the 50 states or D.C., then yes. In some states, genetic counselor licensure law explicitly allows genetic counselors to order testing independently (FL, GA, IN, IL, IA, KY, MD, MN, MS, MT, NH, ND, NV, RI, SC, SD, WI, VA, WV). For patients in other states, Grey Genetics works with a third-party physician group that can authorize test orders in all 50 states and D.C. for self-pay testing or testing billed to commercial insurance. (Our physician partner cannot authorize tests that will be billed to Medicare or Medicaid.) A $25 fee applies per test order. If you want your health insurance to cover the cost of testing, in some cases paying a $25 fee to order under a physician may be the best route — even if you are located in a state where genetic counselors can order testing independently. Your insurance may want the test ordered under an MD's NPI. Your genetic counselor can help you think through which approach makes sense for your situation.

Yes. A full appointment is still the right approach — a thorough review of your personal and family health history gives essential context for your results, even if testing has already been done. Book a standard initial genetics consult and upload any relevant records when scheduling.

Information you share with Grey Genetics is kept private. Since Grey Genetics does not accept insurance, we are not obligated to share any information with your insurer. Consult notes are sent to you by secure email and can be shared with your healthcare provider only at your discretion. Grey Genetics will only discuss your case with your healthcare provider if you give us explicit permission. Whether you are a public figure looking for more discretion than is possible with an in-person hospital consult, or simply an individual who values privacy, your information is treated with the same respect. For more details, see our Privacy Practices and Terms of Service.

Yes to both. You may schedule your appointment and receive your consult note under a name other than your legal name. For genetic testing, laboratories require two matching patient identifiers — typically a name and date of birth — between the requisition form and the sample. If testing is self-pay and not going through insurance, there is no requirement that those identifiers be your legal name. Your genetic counselor can talk through this with you.

No. We will not review your VCF or BAM files.

"Raw data" is often low quality. Even if you have high quality data, Grey Genetics does not have the tools to provide meaningful review of your data. Clinical laboratories use both bioinformatics tools and human expertise to ensure quality control when reporting variants, and classifying variants typically involves a multidisciplinary team. If you have questions about a clinical report, the lab that performed the testing is the right starting point.

If you have uploaded genetic data to a third-party tool and have one or two specific variants of concern, our DTC appointment is designed for that scenario. We ask that you provide information related only to your 1–2 variants of concern. Follow-up testing in a clinical laboratory is often recommended. The DTC appointment is typically a two-part appointment: an initial session covers your personal and family health history and key concerns, and your genetic counselor then schedules a no-charge follow-up to discuss findings after researching your variants of interest.

This is often true.... but not always! Most people's DNA is organized on 46 chromosomes. Those with 46,XX chromosomes are typically assigned female at birth; those with 46,XY are typically assigned male at birth. For many individuals, one of these two categories is an easy fit, and this is a simple and helpful framework for thinking about many genetics, health, and social issues. However, it is also a simplification — and one that has contributed to many misconceptions about sex and gender.

The way our bodies grow and develop depends not on how our DNA is organized but on which genes we have and how they work.... and there are about 25,000 of them. There are many recognized differences of sexual development (DSD) for which the genetic basis is well understood. There is also still a lot we don't understand. (To hear from one Intersex person who shared their story on the Grey Genetics Patient Stories podcast, go here.)

Terms and frameworks used in science and genetics are derived from cultural context and assumptions. The idea of two genders corresponding to two binary sexes (male/female) is really a social construct. An individual's gender may or may not match the sex they were assigned at birth. There is no genetic test for gender. We just have to listen.