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Your Complete Clinical Partner

CPT codes, sample clinical reports, verified ordering workflows, board-certified medical director oversight, and 24/7 genetic counselor support — everything your practice needs to deliver precision genetic medicine with confidence.

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5,000+
Provider Partners
200K+
Tests Ordered
48 hrs
Avg Turnaround

CPT Codes & Billing Reference

20+ verified CPT codes with 2026 CMS/Medicare fee schedules and reimbursement estimates for oncology, PGx, and carrier screening panels.

View Full CPT Table

Medical Director Oversight

Dr. Arjun Patel, MD PhD FACMG — CLIA Laboratory Director with 200+ publications and 19+ years in clinical genetics.

Meet Our Lab Director

Physician-Ready Sample Report

Annotated clinical reports with ACMG variant classification, drug-gene interaction alerts, and actionable physician recommendations.

Preview Report

7-Step Ordering Workflow

From provider registration to AI-validated test submission — full EHR integration with HL7 FHIR, SSO, and real-time status tracking.

See Full Workflow
CLIA Certified Lab
CAP Accredited
ABMGG Board Certified
24/7 Genetic Counseling
EHL HL7 FHIR Ready
BILLING & REIMBURSEMENT

CPT Codes Reference Table

Complete billing code reference for genetic testing services. Pre-verified against CMS, commercial payer, and Medicare fee schedules for 2026.

CMS VerifiedMedicare 2026 ScheduleCommercial Payer Ready
81432Hereditary Cancer

Hereditary breast cancer-related disorders (e.g., BRCA1, BRCA2) — full gene sequence analysis

Genes: 2$2,100 – $2,800
81433Hereditary Cancer

Hereditary breast cancer-related disorders — duplication/deletion analysis

Genes: 2$850 – $1,200
81445Hereditary Cancer

Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis — 5-50 genes

Genes: 50$1,400 – $2,200
81450Hereditary Cancer

Targeted genomic sequence analysis panel, hematolymphoid neoplasm — 5-50 genes

Genes: 50$1,400 – $2,200
81455Hereditary Cancer

Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm — >50 genes

Genes: 108$2,800 – $4,500
81479Pharmacogenomics

Unlisted molecular pathology procedure — custom panels, novel biomarkers, and research assays

Genes: 230Varies — submit for review
81225Pharmacogenomics

CYP2C19 gene analysis — common variants (e.g., *2, *3, *17) for clopidogrel & PPI metabolism

Genes: 1$180 – $260
81226Pharmacogenomics

CYP2D6 gene analysis — common variants (*3-*6, *9, *10, *17, *41) for antidepressant & tamoxifen metabolism

Genes: 1$180 – $260
81227Pharmacogenomics

CYP2C9 gene analysis — common variants (*2, *3) for warfarin & NSAID sensitivity

Genes: 1$180 – $260
81230Pharmacogenomics

CYP3A4 gene analysis — common variant (*22) for statin & immunosuppressant metabolism

Genes: 1$160 – $240
81231Pharmacogenomics

CYP3A5 gene analysis — common variants (*3, *6, *7) for tacrolimus & chemotherapy metabolism

Genes: 1$160 – $240
81350Pharmacogenomics

SLCO1B1 gene analysis — common variant (*5) for simvastatin-induced myopathy risk

Genes: 1$160 – $240
81400Pharmacogenomics

Molecular pathology procedure, Level 1 — single analyte (e.g., VKORC1, F5, F2, MTHFR)

Genes: 1$120 – $180
81401Pharmacogenomics

Molecular pathology procedure, Level 2 — single analyte with common variants (e.g., HLA-B*57:01, TPMT, DPYD)

Genes: 1$140 – $200
81408Comprehensive

Molecular pathology procedure, Level 9 — full gene sequence analysis (e.g., CFTR, DMD, HBA1/HBA2)

Genes: 1$900 – $1,400
81442Pediatric / Inherited

Noonan spectrum disorders gene analysis panel — 5-50 genes (PTPN11, SOS1, RAF1, KRAS, NRAS, BRAF, MAP2K1, SHOC2, CBL)

Genes: 9$1,200 – $1,800
81443Pediatric / Inherited

Genetic testing for severe inherited conditions (e.g., SMA, CF) — carrier screening panel

Genes: 3$600 – $950
81228Pharmacogenomics

CYP2C19 gene analysis — full sequence (all exons) for rare variant detection

Genes: 1$450 – $650
81435Hereditary Cancer

Hereditary colon cancer disorders (e.g., Lynch syndrome) — 5-50 genes including MLH1, MSH2, MSH6, PMS2, EPCAM

Genes: 5$1,400 – $2,000
81437Hereditary Cancer

Hereditary colon cancer disorders — duplication/deletion analysis for Lynch syndrome genes

Genes: 5$700 – $1,100

Download Full CPT Codes + ICD-10 Crosswalk

Complete billing guide with modifier guidance, prior auth checklists, and payer-specific reimbursement rates. Updated monthly.

Request PDF

Reimbursement rates are estimates based on 2026 Medicare fee schedules and may vary by payer, region, and patient coverage. Always verify with your billing department.

ORDERING WORKFLOW

7-Step Provider Ordering Process

From provider registration to clinical report delivery — every step is optimized for speed, accuracy, and seamless EHR integration. Average turnaround: 48 hours.

48 hrs
Average TAT
200+
Orders / Hour
99.8%
Auto-Validation
24 hrs
Kit Delivery
STEP 01
1–2 business days

Provider Registration

Complete the online partnership application with practice NPI, state license verification, and estimated monthly test volume. Our provider relations team reviews and approves within 1–2 business days.

NPI & state license verification
HIPAA Business Associate Agreement (BAA) executed
CLIA laboratory director co-signing protocols
Provider portal credentials issued
STEP 02
2–4 hours

EHR Integration Setup

Our integration engineers configure HL7 FHIR or direct API connections to your EHR system (Epic, Cerner, Athenahealth, eCW, Allscripts, or custom). Patient demographics, ICD-10 codes, and insurance data auto-populate on the first order.

STEP 03
< 60 seconds

Place Test Order

Select the appropriate genetic test panel from our catalog of 10+ CLIA-certified assays. AI-powered clinical appropriateness checks validate ICD-10 coding, insurance pre-authorization status, and prior order history before submission.

STEP 04
Real-time

AI Validation & Quality Review

Every order passes through our AI-driven validation pipeline: clinical appropriateness scoring, drug-gene interaction screening, insurance coverage verification, and patient eligibility confirmation. Flagged orders are escalated to our board-certified genetic counselors for review.

STEP 05
24–48 hours

Kit Shipped / Specimen Collected

For at-home saliva kits, the patient receives the DNA collection kit via overnight courier within 24 hours. For in-clinic blood draws, the specimen is shipped in a pre-labeled CLIA-compliant transport container with chain-of-custody tracking.

STEP 06
36–48 hours from receipt

Lab Processing & Analysis

Samples are processed in our CLIA-certified Chicago laboratory using Agena Bioscience MassArray MALDI-TOF mass spectrometry. Genotyping covers 230+ genes with 99.9% accuracy against Sanger sequencing reference standards. CAP proficiency testing passed every cycle.

STEP 07
48 hours total turnaround

Physician-Ready Report Delivery

Board-certified medical director reviews variant classifications per ACMG/AMP guidelines. Reports are delivered to your EHR inbox, provider portal dashboard, and patient portal simultaneously. Genetic counseling referrals are auto-triggered for pathogenic findings.

CLINICAL OVERSIGHT

Medical Director & Laboratory Director

Clinical oversight, variant interpretation standards, and quality benchmarks are overseen by our board-certified Medical Director.

Dr. Arjun Patel, MD PhD FACMG — GeneMatrix Medical Director
Active Laboratory Director

Dr. Arjun Patel

MD, PhD, FACMG

19+
Years in Clinical Genetics
200+
Peer-Reviewed Publications
15K+
Cases Supervised
FACMG
Board Certification

External Profiles

PubMed Author ProfileNorthwestern Faculty PageLinkedIn Profile

Dr. Arjun Patel, MD, PhD, FACMG

Medical Director & CLIA Laboratory Director, GeneMatrix AI

Dr. Arjun Patel is a board-certified medical geneticist and molecular pathologist with over 19 years of clinical and research experience in hereditary cancer syndromes, pharmacogenomics, and computational genomics. He serves as both the Medical Director and CLIA Laboratory Director for GeneMatrix AI, overseeing clinical interpretation protocols, variant classification standards, and CAP-accredited quality management systems for all laboratory operations at our Chicago, Illinois facility (CLIA ID: 14D2276402).

Before joining GeneMatrix, Dr. Patel served as Associate Professor of Human Genetics at Northwestern University Feinberg School of Medicine and directed the Hereditary Cancer Genomics Program at Northwestern Memorial Hospital. His clinical research has focused on multi-gene panel testing for hereditary breast and ovarian cancer, Lynch syndrome, and polygenic risk stratification — with over 200 peer-reviewed publications in journals including Nature Genetics, The Lancet, JAMA, and Journal of Clinical Oncology.

Dr. Patel leads GeneMatrix's Medical Advisory Board in establishing clinical reporting standards, establishing variant interpretation tiers, and validating AI-assisted genomic analysis pipelines. All clinical reports issued by GeneMatrix are reviewed under the oversight protocols he designed, ensuring that variant classifications meet ACMG/AMP classification guidelines and that clinical recommendations follow current NCCN, CPIC, and FDA pharmacogenomics guidelines.

He is a Fellow of the American College of Medical Genetics and Genomics (FACMG), a member of the American Society of Human Genetics (ASHG), and an active contributor to the Clinical Pharmacogenomics Implementation Consortium (CPIC). He holds dual board certification from the American Board of Medical Genetics and Genomics (Clinical Genetics) and the American Board of Internal Medicine.

Precision medicine only delivers on its promise when every genetic interpretation is grounded in rigorous evidence, transparent clinical reasoning, and the humility to acknowledge uncertainty. At GeneMatrix, we built a reporting standard that clinicians can trust — because patients deserve nothing less.

Dr. Arjun Patel, MD, PhD, FACMG

Medical Director, GeneMatrix AI

CLIA Certified Lab

CLIA ID: 14D2276402

CAP Accredited

College of American Pathologists

ABMGG Certified

American Board Med Genetics

SAMPLE REPORT

Physician-Ready Clinical Reports

Reports are structured for clinical workflows — clear variant classification, ACMG-tier ratings, actionable recommendations, and physician co-signature by our CLIA-certified lab director.

GeneMatrix AI — Clinical Genetics Report
CLIA: 14D2276402 · NPI: 1225729312 · CAP Accredited
FINAL REPORTCPT: 81455
Patient ID
PT-2025-44881
Accession
GM-2025-ACC-88123
Report Date
May 2, 2026
Ordered By
Dr. Kathleen Moore, MD

GeneCancer — 108-Gene Hereditary Cancer Panel

Ordered by: Dr. Kathleen Moore, MD — Northwestern Memorial Hospital

Gene Results — Selected Findings

BRCA1Pathogenic

c.5266dupC (p.Gln1756ProfsTer25)

Hereditary Breast/Ovarian Cancer

BRCA2Negative

No pathogenic variant detected

—

TP53Negative

No pathogenic variant detected

—

MLH1Negative

No pathogenic variant detected

—

PALB2Likely Pathogenic

c.1592delT (p.Leu531TrpfsTer7)

Hereditary Breast Cancer

Clinical Significance

Two clinically significant variants identified. BRCA1 c.5266dupC is a well-characterized pathogenic founder variant (5382insC) associated with significantly elevated lifetime risk for breast cancer (57–65%) and ovarian cancer (39–46%). PALB2 variant is classified as Likely Pathogenic per ACMG/AMP criteria.

Clinical Recommendations

  • 1
    Refer to high-risk oncology breast program for intensive surveillance (annual MRI + mammography, starting immediately)
  • 2
    Discuss risk-reducing surgery options (bilateral prophylactic mastectomy, bilateral salpingo-oophorectomy)
  • 3
    Recommend cascade testing for first-degree relatives; BRCA1 mutation testing is recommended for all at-risk family members
  • 4
    Refer to genetic counselor for comprehensive risk assessment, pedigree review, and familial counseling
  • 5
    Consider platinum-based chemotherapy or PARP inhibitor therapy if cancer diagnosis is made — BRCA1 tumors show preferential response
Dr. Arjun Patel, MD, PhD, FACMG
Medical Director & CLIA Laboratory Director
Reviewed: May 3, 2026 · CLIA ID: 14D2276402
Digitally Signed & Validated

This report was generated and validated under CAP/CLIA-accredited quality management protocols. Variants are classified per ACMG/AMP 2015 guidelines. Drug-gene interactions follow CPIC Level A–B guidelines. All recommendations should be reviewed in the context of patient clinical history. This report does not constitute medical advice.

Request Full Sample Report (PDF)
GET IN TOUCH

Start Your Provider Partnership

Complete the form below and our provider relations team will contact you within 1–2 business days with onboarding details, integration timelines, and a personalized contract proposal.

Provider Hotline
(847) 302-9668
Mon–Fri 8AM–5PM CT
Provider Relations Email
partnerships@genematrix.io
Average response: 4 hours
Clinical Laboratory
1375 W Fulton St STE 545
Chicago, IL 60607
Schedule a Demo
Book a 30-min demo call
With our clinical integration team

Why Providers Choose GeneMatrix

CLIA-certified laboratory with CAP accreditation
99.9% accuracy validated against Sanger sequencing
Average 48-hour turnaround time
Dedicated genetic counselor on every pathogenic case
EHR integration with 200+ systems supported

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