Is Fragile X testing covered by Medicare?

Fragile X DNA testing is funded by Medicare under the following conditions:

  • Medicare item 73300 in the following circumstances: detection of genetic mutation of the FMR1 gene by nucleic acid amplification (NAA) where:
  • (a) The patient exhibits intellectual disabilities, ataxia, neurodegeneration, or premature ovarian failure consistent with a FMR1 mutation; or
  • (b) The patient has a relative with the FMR1 mutation.
  • Medicare item 73305: Detection of genetic mutation of the FMR1 gene southern blot where the results in item 73300 are inconclusive.

The name of the test is DNA Studies for Fragile X syndrome.

Please check with Medicare if you have any concerns.