Provider FAQs: Billing

Invitae’s billing structure is designed to support flexibility and the ability to customize orders, while keeping bills low. Our panel tests are billed “per clinical area,” which means that a clinician can select a pre-curated test, combine multiple tests, or customize their own test for each patient—including re-requisition—without incurring additional charges as long as all genes ordered fall within a single clinical area.

Orders that include genes in two different clinical areas will require two sample tubes and will result in two reports generated by two different teams of clinical experts. Please be aware that your order will also represent two billable events, one for each clinical area.

Please view our online test catalog or clinical areas flyer to see the clinical areas. Note that all genes included in each of our pre-curated panels—including their preliminary-evidence and add-on genes—fall within a single clinical area.

Invitae offers insurance billing (including Medicare/Medicaid), institutional billing, a patient assistance program (for those who met eligibility criteria), flexible payment plans, and more.

With the Invitae Billing Assurance Program, our dedicated billing specialists work with each patient to get a comprehensive view of their individual situation and help identify cost-effective and affordable payment options.

As payment specifics may differ based on the test ordered, please view our dedicated billing webpage to learn more. You can also contact our billing team at billing@invitae.com or 833-941-0828.

For patients who are located in the United States (and US territories) and meet eligibility criteria, the cost of testing may be either partially discounted or entirely waived, depending on income-based eligibility requirements. Your patients can see if they qualify for the patient assistance program by using our online estimator on our patient billing page. You can learn more by looking at our patient assistance program application.

Invitae is proud to be in network with national US payers, covering more than 300 million patients in the United States. Invitae can also work with out-of-network insurance providers.

You can view our full list of in-network insurance providers here.

Invitae can bill insurance directly for patients in the United States. Please be prepared to provide the following information with your order:

• Patient's first and last name, phone number, and mailing address
• A copy (front and back) of the patient's insurance card
• Updated ICD-10 codes
• Letter of Medical Necessity
• Any necessary preauthorization forms, which can be found on the forms page

This information can be entered during the online ordering process, when third-party insurance billing is selected as the form of payment.

Yes, Invitae does offer precertifications for insurance billing within the United States. For more information, please see the precertification forms on the forms page or contact Client Services about how we can help with precertifications for your patients. Regardless of whether a patient is in-network or out-of-network, Invitae is committed to making genetic testing affordable.

Invitae defers to the ordering healthcare provider to select the appropriate diagnosis codes for each order. To identify the appropriate ICD-10 code(s), we recommend reviewing the resources posted on the Centers for Medicare & Medicaid Services (CMS) website.

In addition, this flyer may be of use for cancer-related ICD-10 codes. If you need help, please contact Client Services.

The answer depends on the type of testing ordered.

Diagnostic panel testing

Invitae accepts Medicare (including managed Medicare) for all diagnostic panel (and single-gene) orders.

To bill Medicare for panel (and single gene) testing, please submit an order either using Invitae’s online portal or a paper order form and select the Medicare billing option. Because Invitae’s criteria are broader than Medicare criteria, we request that the following be included to support any appeals that may be necessary:

• A letter of medical necessity (available here)
• A signed informed consent form, (available here; please ensure the informed consent form is dated on or before the date of blood draw)
• A detailed family history or pedigree
• Any applicable medical records

Note that although patients may receive an explanation of benefits from Medicare, this is not a bill. Most patients billing Medicare for a panel test will receive no bill.

Exome testing & pediatric

Invitae does not accept Medicare (or managed Medicare) for exome or pediatric testing.

The answer depends on the type of testing ordered.

Diagnostic panel testing

Invitae accepts Medicaid (including managed Medicaid) for all panel (and single-gene) orders.

To bill Medicaid for a panel test, please submit an order either using Invitae’s online portal or a paper order form and select the Medicaid billing option. Because Invitae’s criteria are broader than Medicaid criteria, we request that the following be included to support any appeals that may be necessary:

• A letter of medical necessity (available here)
• A signed informed consent form, (available here; please ensure the informed consent form is dated on or before the date of blood draw)
• A detailed family history or pedigree
• Any applicable medical records
• Note that although patients may receive an explanation of benefits from Medicaid, this is not a bill. Most patients billing Medicaid for a panel test will receive no bill.

Exome testing

Invitae accepts Medicaid or managed Medicaid as a third-party billing option for exome orders only when placed in states listed below. For all other states, we offer a payment option where Invitae can client bill your practice or institution at a reduced rate; please contact Invitae for more information. No contract is required.

States where Medicaid IS ACCEPTED for exome: Arizona, Connecticut, Florida, Idaho, Kentucky, Maryland, Minnesota, Missouri, North Dakota, New Jersey, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Utah, Virginia and Washington.