Summary & Overview
CPT 81440: Genomic Sequencing Procedures and Multianalyte Assays
Headline: Genomic Sequencing CPT 81440 Gains Broad Payer Coverage for Advanced Molecular Diagnostics
Lead: CPT code 81440 represents a pivotal advancement in molecular diagnostics, enabling comprehensive genomic sequencing procedures that are increasingly integral to clinical care across the United States.
CPT code 81440 is used for Genomic Sequencing Procedures and Other Molecular Multianalyte Assays, supporting the identification of genetic variants linked to a wide spectrum of conditions, including chromosomal abnormalities, metabolic disorders, and neurodevelopmental syndromes. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its growing importance in medical genetics and clinical practice.
This publication provides an in-depth overview of CPT 81440, including payer coverage benchmarks, policy updates, and clinical context. Readers will gain insight into the code’s role in precision medicine, its relevance for medical genetics specialists, and the associated ICD-10 diagnoses commonly linked to genomic sequencing. The analysis also highlights related CPT codes and common billing modifiers, offering a comprehensive resource for understanding the evolving landscape of molecular assay reimbursement and utilization.
With expanding payer coverage and clinical adoption, CPT 81440 is positioned as a key code in the transition toward personalized medicine and advanced genetic testing.
CPT Code Overview
CPT 81440 is designated for Genomic Sequencing Procedures and Other Molecular Multianalyte Assays. This code is used to report advanced molecular diagnostic testing that involves sequencing multiple genes or regions of the genome to identify genetic variants associated with a range of clinical conditions. The service type encompasses comprehensive genomic analysis, which is increasingly utilized in medical genetics for diagnosis, prognosis, and therapeutic decision-making. Typical site of service information is not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient presents with clinical features suggestive of a genetic disorder, such as unexplained developmental delay, metabolic abnormalities, or neurological symptoms. The provider, typically a specialist in medical genetics, determines that a comprehensive genomic sequencing procedure is necessary to identify potential genetic mutations or chromosomal abnormalities. The workflow involves collecting a specimen (such as blood or saliva), performing high-throughput sequencing, and interpreting the results to guide diagnosis and management. This procedure is commonly performed in specialized laboratories and interpreted by medical geneticists.
Coding Specifications
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Modifier
26: Used to indicate the professional component of the service, which includes interpretation and reporting by a qualified provider. -
Modifier
TC: Used to indicate the technical component, which covers the laboratory work and equipment used for sequencing.
| Provider Taxonomy Code | Specialty Description |
|---|---|
207SG0201X | Medical Genetics, Clinical Genetics (M.D.) |
207SG0202X | Medical Genetics, Clinical Biochemical Genetics |
207SG0203X | Medical Genetics, Clinical Molecular Genetics |
207SG0205X | Medical Genetics, Ph.D. Medical Genetics |
Related Diagnoses
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Q99.9: Chromosomal abnormality, unspecified- Relevant for patients with suspected chromosomal disorders where genomic sequencing may identify underlying abnormalities.
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E88.9: Metabolic disorder, unspecified- Used when a metabolic disorder is suspected and genomic sequencing can help pinpoint genetic causes.
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F84.0: Autistic disorder- Applied when evaluating patients with autism spectrum disorder to investigate potential genetic etiologies.
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Q90.9: Down syndrome, unspecified- Used for patients with features of Down syndrome, where genomic sequencing may confirm or further characterize the chromosomal abnormality.
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G11.9: Hereditary ataxia, unspecified- Relevant for patients with unexplained ataxia, where sequencing can identify hereditary causes.
Related CPT Codes
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81441: Genomic Sequencing Procedures and Other Molecular Multianalyte Assays- Used for similar sequencing procedures, often as an alternative or in conjunction with
81440depending on the clinical indication and scope of analysis.
- Used for similar sequencing procedures, often as an alternative or in conjunction with
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81439: Genomic Sequencing Procedures and Other Molecular Multianalyte Assays- Related to
81440and may be used for different panels or sequencing approaches. These codes are commonly considered together when determining the most appropriate test for a patient.
- Related to
National Reimbursement Benchmarks
National mean rates for CPT code 81440 among commercial payers are notably higher than typical Medicare rates, with BUCA (average commercial) at $2,409.98. Individual commercial payers such as Blue Cross Blue Shield, UnitedHealth Group, and Cigna all report mean rates above $2,500, while Aetna is slightly lower at $2,071.52.
Rate dispersion varies significantly across payers. Cigna exhibits the widest spread, with a difference of $2,880.50 between the 75th and 25th percentiles, indicating substantial variability in reimbursement. In contrast, Aetna has the tightest range at $1,725.00, suggesting more consistent rates. Blue Cross Blue Shield, UnitedHealth Group, and BUCA fall in between, with ranges of $1,828.00, $1,625.48, and $1,511.50, respectively.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.