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S0265 Genetic counsel 15 minutes

S Codes

Also known as: genetic counseling, genetic eval

Genetic counseling, 15 minutes. Non-physician genetic education about disease inheritance, risk, and management options.

In Plain Language

hereditary disease discussion; genetics consultation

Clinical Context

Performed by certified genetic counselor for patients with hereditary conditions, cancer risk, carrier screening, or prenatal concerns. Includes pedigree analysis and risk assessment.

RVU Information

CPT S0265 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.

Billing & Documentation

S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.

Specialties

GeneticsOncologyObstetrics

Frequently Asked Questions

What is CPT code S0265?

CPT S0265 (Genetic counsel 15 minutes) is a S Codes code. Genetic counseling, 15 minutes. Non-physician genetic education about disease inheritance, risk, and management options.

Is S0265 covered by insurance?

S0265 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Performed by certified genetic counselor for patients with hereditary conditions, cancer risk, carrier screening, or prenatal concerns. Includes pedigree analysis and risk assessment.

When is CPT S0265 used?

Performed by certified genetic counselor for patients with hereditary conditions, cancer risk, carrier screening, or prenatal concerns. Includes pedigree analysis and risk assessment.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.