GeneSight Test Cost in 2026: Medicare Rate, Insurance, Self-Pay

The public numbers

Six figures that explain the GeneSight price

One number is what Medicare pays the laboratory. The rest are what the laboratory says patients pay. Mixing them up is why cost answers online seem to contradict each other.

Figure	Amount	What it means	Source
Medicare's 2026 payment to the lab, code 0345U	$1,336.09	What Medicare pays the laboratory for one GeneSight Psychotropic test. Lab fee schedule rates are national, so the amount is the same in every state.	CMS Clinical Laboratory Fee Schedule, 2026
Medicare Part B, covered Medicare Advantage tests, Medicaid	$0 typical	The lab's statement of what these patients typically pay. Medicare Part B does not apply a deductible or coinsurance to covered lab tests.	GeneSight cost page; Medicare.gov
Commercial or other insurance	$330 or less typical	The lab's typical cost for commercial or other plans. Across all patients, it says 98% pay $330 or less, based on 12 months of past claims for major insurers, last updated in 2026.	GeneSight cost page
Uninsured or choosing self-pay	$330	The lab says all patients are eligible for a reduced self-pay option of $330.	GeneSight cost page
Payment plan	$100 or more	The lab offers an interest-free plan of up to 12 months when the cost is $100 or more, regardless of insurance or income.	GeneSight cost page
The Medicare figure still quoted online	$1,569	The Medicare rate as of September 2020, published in American Family Physician in 2021. The 2026 rate is $232.91 lower.	AAFP 2021; CMS 2026

The CMS lab fee schedule lists 0345U as a psychiatry genomic analysis panel: variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6. It is a proprietary laboratory analyses code, which means it applies to one laboratory's test, the GeneSight Psychotropic panel. Other pharmacogenomic panels bill under different codes and rates, so a price for one test does not carry over to another.

With Medicare

Covered usually means $0. Not covered means a waiver you sign.

Medicare.gov says you usually pay nothing for Medicare-covered diagnostic laboratory tests. The question to settle before the swab is whether Medicare will cover this test for you.

MedPAC, the congressional advisory commission on Medicare payment, notes that services paid under the lab fee schedule carry no beneficiary cost sharing and that the rates do not vary by geography. Coverage is a separate question: Medicare contractors decide it for pharmacogenomic panels through regional policies, such as the pharmacogenomics billing article Novitas publishes.

The laboratory's cost page states: “For Medicare, if the test is considered non-covered, your clinician will need to submit an Advanced Beneficiary Notice signed by you before we can deliver the GeneSight test. By signing the ABN, you agree to pay the full cost of the test and will be billed accordingly.” The same page says all patients are eligible for the $330 self-pay option. Before signing, ask the laboratory which amount you would owe in dollars. The laboratory also says people with federally funded coverage, including Medicare, Medicaid, TRICARE, and Medicare Advantage, are not eligible for its financial assistance program.

With commercial insurance or none

The laboratory checks benefits after it receives the sample.

The laboratory says it reviews your insurance benefits when your sample arrives and contacts you before processing if your cost could be more than $330, including the option to cancel at no cost.

If you are insured, the laboratory bills the plan after processing. It says the plan's Explanation of Benefits arrives in 30 to 45 days and is not a bill, and that the laboratory's own statement can take several months. Plans decide coverage for pharmacogenomic panels under their own medical policies, so ask the plan directly about code 0345U, prior authorization, and whether the laboratory is in network. If your estimated share is higher than $330, compare it with the self-pay option before the test is processed.

Printable checklist

Ask these questions before the cheek swab.

Record who answered, the date, and the reference number. Keep insurance details with your care team and the laboratory; Advanced Depression Care does not collect them.

Which test is being ordered, and which code will be billed? GeneSight Psychotropic bills under 0345U.
Does my plan cover code 0345U, and does it need prior authorization?
With Medicare: am I being asked to sign an Advance Beneficiary Notice? If so, what dollar amount would I owe?
Would the $330 self-pay option cost less than my insurance estimate?
Will the laboratory contact me before processing if my cost could be more than $330?
If I owe $100 or more, can I use the interest-free payment plan?
Who will review the report with me, and when?
Would any result change my medication plan now? If not, why test today?

Read the results guide

Is it worth the cost?

Ask what the result would change before paying for it.

The evidence supports using a pharmacogenomic result as one input for selected patients, not as a routine test or a promise of response.

American Family Physician's 2021 review says the GeneSight test may assist drug selection and dosing for people having difficulty finding an effective option or who have had intolerable adverse effects after trials of several drugs, and states that routine genetic testing is not recommended. In the PRIME Care randomized trial (JAMA, 2022), 1,944 patients with major depressive disorder at 22 VA medical centers were assigned to care guided by a commercial pharmacogenomic test or to usual care. Test-guided care led to more prescriptions with no predicted drug-gene interaction. Remission over 24 weeks was slightly higher (a 2.8 percentage-point risk difference), but the difference was not significant at week 24.

Do not stop, skip, switch, or change the dose of a medication because of a report category. Review the full report with the prescriber responsible for the plan. Our antidepressant genetic testing guide explains how to read report categories and the evidence behind them.

Common questions

GeneSight cost and coverage questions

How much does the GeneSight test cost?

Medicare's 2026 Clinical Laboratory Fee Schedule pays $1,336.09 for the test, which is billed under code 0345U. What a patient pays is usually far less: the lab says $0 is typical with Medicare Part B, covered Medicare Advantage tests, and Medicaid, that 98% of patients pay $330 or less, and that every patient can choose a $330 self-pay option.

Does Medicare cover the GeneSight test?

Medicare can pay for the test when it meets the coverage policy that applies, and a covered lab test usually costs the patient nothing because Part B does not apply its deductible or coinsurance to it. If Medicare considers the test non-covered in your situation, the lab says your clinician must submit an Advance Beneficiary Notice signed by you, and that signing it means agreeing to pay the full cost. Ask for the dollar amount in writing before you sign.

How much is GeneSight without insurance?

The lab lists a reduced self-pay price of $330 and says all patients are eligible for it. It also offers an interest-free payment plan of up to 12 months when the cost is $100 or more. Its financial assistance program is not available to people with federally funded coverage such as Medicare, Medicaid, TRICARE, or Medicare Advantage.

What is the CPT code for the GeneSight test?

GeneSight Psychotropic is billed under 0345U, a proprietary laboratory analyses code that applies only to that test. The CMS lab fee schedule describes it as a psychiatry genomic analysis panel: variant analysis of 15 genes, including deletion/duplication analysis of CYP2D6.

Why do some websites say Medicare pays $1,569 for GeneSight?

That figure is the Medicare payment rate as of September 2020, published in American Family Physician in 2021. The 2026 rate in the CMS lab fee schedule is $1,336.09. Neither number is what a patient usually pays; it is what Medicare pays the laboratory.

Is the GeneSight test worth the cost?

It depends on the decision it is meant to inform. American Family Physician says the test may help people who have had trouble finding an effective medication or had intolerable side effects after several trials, and that routine genetic testing is not recommended. In the PRIME Care trial of a commercial pharmacogenomic test, results changed prescribing toward medications with fewer predicted drug-gene interactions, while the remission benefit was small and not significant at 24 weeks. Ask the prescriber whether a result would change the plan now.

Primary and official sources

Check the rate, the terms, and the evidence directly.

All sources were read September 24, 2026. Laboratory cost statements are the laboratory's own and can change; the Medicare rate is what Medicare pays the laboratory, not a patient price. This page does not endorse a test brand or laboratory, interpret a personal result, or recommend a medication change.