Genetic and metabolic medicine
Indications for referral to clinical genetics services
Who to refer to clinical genetics or a familial cancer centre, what you can test yourself under Medicare, carrier screening, prenatal and preimplantation testing, metabolic presentations in adults, and how to make a referral useful.
Tier 2Topic overview
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Clinical genetics services in Australia are mostly public, state-based units in tertiary hospitals, with outreach clinics. Familial cancer centres handle hereditary cancer. Genetic metabolic services handle inborn errors. Waits for non-urgent referrals can be months, so mark urgency (pregnancy, active cancer treatment, acute metabolic illness).
- Refer when a diagnosis, predictive or reproductive decision or family follow-up depends on genetic expertise. Many straightforward tests no longer need a geneticist: mainstreamed testing in oncology, cardiology and neurology is now usual.
- The RCPA and HGSA joint guideline (April 2026) says predictive, prenatal and most diagnostic genetic tests should be requested by a medical specialist with relevant expertise, or one working with a genetic counsellor.
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Sources
- Guideline: Requesting medical human genetic testing (joint RCPA Genetics Advisory Committee and HGSA statement 1/2026, approved 23 April 2026)AU/NZHuman Genetics Society of Australasia and Royal College of Pathologists of Australasia, 2026
- Requirements for medical testing for human genetic variation, fourth edition (NPAAC)AU/NZAustralian Commission on Safety and Quality in Health Care, 2025, amended March 2026
- MBS factsheet: amendment of MBS item 73451 (reproductive carrier testing for cystic fibrosis, spinal muscular atrophy and fragile X syndrome) from 1 November 2024AU/NZAustralian Government Department of Health, Disability and Ageing, 2024
- MBS Online: item 73452 (reproductive partner testing for CFTR or SMN1)AU/NZAustralian Government Department of Health, Disability and Ageing, 2026
- Budget 2026-27: Health and disability (amendments to MBS items 73358, 73359 and 73360 from 1 November 2026)AU/NZServices Australia, 2026
- Kirk EP et al. Nationwide, couple-based genetic carrier screening (Mackenzie's Mission). N Engl J Med 2024;391:1877-1889AU/NZNew England Journal of Medicine, 2024
- Recommendations for the predictive genetic test in Huntington's disease (MacLeod R et al. Clin Genet 2013;83:221-31)Clinical Genetics, 2013
- eviQ cancer genetics referral guidelinesAU/NZCancer Institute NSW
- Ethical guidelines on the use of assisted reproductive technology in clinical practice and research (2017, updated 2023)AU/NZNational Health and Medical Research Council, 2023
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback