Adoption of next generation sequencing (NGS) panel testing has allowed for simultaneous testing of multiple genetic causes and decreased the cost of genetic testing. Technical standards for diagnostic gene sequencing panels have been developed by the American College of Medical Genetics (ACMG) to promote best practices in panel design and technical considerations, though adherence to these standards is voluntary. Here we review quality measures aimed to optimize test accuracy and clinical utility, using case-based examples to demonstrate impact.