; and (B) by inserting before the semicolon at the end the following: , and (CC) with respect to covered genetic counseling services under section 1861(s)(2)(HH), furnished by a genetic counselor, the amount of payment for such service shall be an amount equal to 85 percent of the lesser of the actual charge for the services or the amount determined under the fee schedule established under section 1848(b) for the same services if furnished by a physician . (2) Modifier Section 1834 of the Social Security Act ( 42 U.S.C. 1395m ) is amended by adding at the end the following new subsection: (w) Use of modifier with respect to genetic counseling services (1) Establishment Not later than January 1, 2019, the Secretary shall establish a modifier to be utilized with evaluation and management CPT codes to indicate (in a form and manner specified by the Secretary), in the case of covered genetic counseling services under section 1861(s)(2)(HH), if such services were furnished by a genetic counselor. (2) Required use Each request for payment, or bill submitted using evaluation and management CPT codes, for covered genetic counseling services (as defined in section 1861(jjj)(1)) furnished by a genetic counselor (as defined in section 1861(jjj)(2)) on or after January 1, 2019, shall include the modifier established under subparagraph (A) for each such service. . (d) Assignment of payment Section 1833(r) of the Social Security Act ( 42 U.S.C. 1395l(r) ) is amended by adding at the end the following new paragraph: (3) Application to genetic counselors The provisions of paragraphs (1) and (2) shall apply with respect to covered genetic counseling services described in section 1861(s)(2)(HH) and genetic counselors (as defined in section 1861(jjj)(2)) in the same manner as such provisions apply with respect to services described in section 1861(s)(2)(K)(ii) and nurse practitioners. . (e) Conforming amendment Section 1862(a)(14) of the Social Security Act (42 U.S.C. 1395(y)(a)(14)) is amended by inserting covered genetic