Genetic Counseling and Testing

Expert genetic counseling at Scripps Cancer Center

A Scripps genetic counselor in a white lab coat represents the expert genetic counseling offered at Scripps Cancer Center.

Expert genetic counseling at Scripps Cancer Center

Genetic testing is done to help determine if a person has an increased risk for developing certain types of cancer that tend to be hereditary. For example, cancer risk may be higher if two or more close family members have the same type of cancer or gene mutation, or the same cancer occurs in several generations of a family. Genetic testing uses a blood sample to look for signs of a higher cancer risk. 


Genetic testing for cancer is not for everyone. Scripps physicians refer individuals or families to one of our certified genetic counselors to discuss whether testing is appropriate and learn more about the process. 


We know that possibly having an increased risk of cancer can cause anxiety, and genetic counseling offers valuable education and expert, compassionate guidance.  


While anyone can see a genetic counselor, not everyone may qualify for genetic testing through their health insurance. In most cases, there are specific coverage guidelines for genetic counseling, so contact your insurance carrier for more information.

What are genetic counselors?

Genetic counselors are health care professionals who specialize in advising individuals and families about genetic disorders. Scripps genetic counselors have advanced education and training in medical genetics and counseling. In addition to providing information and guidance about genetic testing, genetic counselors interpret test results and advise families about their options through education and support.

Who should get genetic counseling?

A physician referral is required to meet with a Scripps genetic counselor. Your physician may recommend genetic counseling if you have: 


  • A family history of hereditary cancers, such as ovarian cancer, colon cancer, breast cancer, pancreatic cancer, etc.
  • Had previous cancer genetic testing that identified a cancer gene mutation
  • Personal history of cancer at a younger age than typically seen
  • Personal history of multiple types of cancer 


If you think you may benefit from genetic counseling, talk with your physician about a referral.

What to expect from genetic counseling

During your first visit with a genetic counselor, the counselor will explain the relationship between genes and hereditary types of cancer. The counselor also will review your personal and family medical history, and perform a cancer risk assessment to evaluate your personal cancer risk and help determine whether genetic testing is an option for you or your family. While anyone can see a genetic counselor, insurance companies have specific guidelines for coverage of genetic testing. 


The decision to have genetic testing is a personal one. Even if the counselor does recommend genetic testing, you are not required to have the test. The counselor will review the benefits and risks of testing, discuss your concerns and help you make an informed decision. Then, you and your family members can decide together if and when to have testing.


Should you decide to have genetic testing, the genetic counselor will talk with you about which family member is the best candidate for testing. Usually, this will be someone who has had cancer. Your counselor also will discuss where to go for testing, how long it will take to get results and the cost. 


At the time of your blood test, the genetic counselor will discuss the estimated length of time it will take the lab to analyze your sample. The range is usually from one to three weeks. The genetic counselor will follow up with you to discuss the results by phone or in person. 


Genetic testing results become part of your medical record and are shared with your health care providers.

Our approach to genetic counseling at Scripps

Scripps genetic counselors provide expert, caring support and education to you and your family. We take a personalized approach to every patient, and will do our best to answer your questions and address your concerns to help you make an informed, confident decision about genetic testing.


Medical insurance may cover genetic testing depending on specific guidelines, such as an individual’s personal history of cancer, age at diagnosis and family history of cancer. Check with your insurance company to find out if genetic testing is covered. If insurance does not cover testing, in some cases a genetic counselor may still recommend testing if there is a high risk for a hereditary cancer syndrome or gene mutation.


Should you decide to have testing, we will help arrange your testing and make sure you understand your results, cost and next steps. Through genetic testing, Scripps genetic counseling team helps individuals and their families understand their cancer risks so that individualized cancer screening and risk reduction plans can be designed.

Frequently asked questions about genetic counseling and testing

What is hereditary cancer?

Hereditary cancer means that a person is born with a potentially harmful change in a gene, called a mutation, that increases their risk of developing cancer. Approximately 5-10% of cancers are hereditary; gene mutations are typically passed down from a parent.

What are the benefits of genetic counseling/genetic testing?

If you are considering genetic testing, genetic counselors can review common concerns about testing, including privacy information and possible insurance discrimination, to help you decide.


After genetic testing, genetic counselors can give cancer screening recommendations specific to your test results, family history, and other risk factors. If a genetic test finds hereditary cancer, these recommendations can be helpful for family members who may be eligible for earlier or more frequent screening.

What happens at a genetic counseling appointment?

The genetic counselor will carefully review your personal and/or family history of cancer. They will discuss what genetic testing is, the possible results, and how these results may impact you and your family members. If you decide to proceed with testing, the counselor will order and coordinate your genetic test. If you decide against testing, the counselor may still make recommendations for cancer screening options based on your personal and/or family history of cancer. For example, some women are eligible for earlier or more frequent breast cancer screening based on their family history of breast cancer and other risk factors.

How is genetic testing performed?

Genetic testing is ordered only after you have met with a genetic counselor. Testing typically requires a blood sample, although saliva can be used in some cases. At the end of your appointment, your genetic counselor will explain how to get your blood drawn for testing, which will usually occur at a Scripps Health facility. It can take up to three weeks to get your test results.

What happens once the results are ready?

Your genetic counselor will review and interpret your results with you and share the information with your providers. Your counselor also will make personalized cancer screening recommendations based on genetic test results and your personal and/or family history of cancer. For example, they may recommend you begin certain cancer screenings, like colonoscopy or mammogram, at a younger age or more frequently than average.

What do I bring to my appointment?

After you schedule your genetic counseling appointment, you will receive a questionnaire about you and your family medical history. Please complete and return this questionnaire prior to your appointment. Please provide as much information as possible; it may be helpful to ask family members to assist in completing the form. Also, if you or anyone in your family has previously had genetic testing specific to hereditary cancer, please bring a copy of their genetic test report or email it to your counselor before your appointment.

Does insurance cover genetic counseling?

Many insurance providers do cover genetic counseling. To confirm whether a genetic counseling consult would be covered, please contact your insurance provider. It may be helpful for your insurance provider to know that the genetic counseling would be done by a licensed, certified genetic counselor. You can provide them with the CPT code 96040 to confirm coverage. (Note that beginning January 1, 2025, the CPT code will change to 96041.) Some insurance providers, including Medicare and Tricare, do not cover genetic counseling. Without insurance, the cost is $262 for a one-hour genetic counseling session. 


During your consultation, the genetic counselor will be able to provide more information about insurance coverage for genetic testing, which is dependent upon your personal and family history of cancer.

What is included in genetic testing?

Genetic testing is specific to hereditary cancer and does not include hereditary risks for other disease (ex. heart disease, Parkinson’s, connective tissue, Alzheimer disease/dementia, etc.).

How do I get a referral for genetic counseling?

Ask your primary care physician or another provider at Scripps to refer you to “Oncology Genetic Counseling.”