20 States + California

Fertility Insurance Mandates
by State

21 US states require health insurers to cover fertility treatments. Each state has different rules — different cycle limits, payer requirements, and billing protocols. EasyRCM helps fertility practices navigate every mandate state, from New York's 3-cycle IVF law to Texas's diagnosis-only requirement.

11 Comprehensive
10 Limited
4 Diagnosis Only

Comprehensive Mandates

States that fully mandate IVF, multiple cycles, and broad ART coverage.

CA
California
Comprehensive
SB 729 — 3 IVF cycles, egg freezing, embryo storage. Effective Jan 1, 2026.
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NY
New York
Comprehensive Mandate
Up to 3 complete IVF cyclesNY Insurance Law §4303(cc)
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IL
Illinois
Comprehensive Mandate
Up to 4 egg retrievals; unlimited embryo transfers215 ILCS 5/356m
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MA
Massachusetts
Comprehensive Mandate
Up to 6 oocyte retrievals per lifetimeM.G.L. c. 175 §47H
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NJ
New Jersey
Comprehensive Mandate
Up to 4 IVF attempts; unlimited IUIN.J.S.A. 17B:27-46.1x
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CT
Connecticut
Comprehensive Mandate
Up to 2 IVF cyclesConn. Gen. Stat. §38a-536
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RI
Rhode Island
Comprehensive Mandate
Covered without a specific cycle limit under the mandate (verify per plan)R.I. Gen. Laws §27-20-20
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WA
Washington
Comprehensive Mandate
Up to 3 IVF cycles; unlimited IUIRCW 48.43.0128 (SB 5765)
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CO
Colorado
Comprehensive Mandate
Up to 3 IVF cycles; 6 IUI cyclesC.R.S. §10-16-104(22) (SB 23-093)
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CA
California
Comprehensive Mandate
Up to 3 egg retrievals; up to 3 embryo transfers (lifetime)Cal. Health & Safety Code §1374.56 / Cal. Ins. Code §10119.9 (SB 729)
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VA
Virginia
Comprehensive Mandate
IVF covered on qualifying fully-insured group plans; lifetime limit of 3 fresh cycles and 3 FET cycles; self-funded ERISA plans exemptVa. Code §38.2-3418.13 (IVF mandate effective July 1, 2020)
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Limited Mandates

States with IVF coverage requirements but restricted scope, cycle limits, or employer size thresholds.

MD
Maryland
Limited Mandate
Up to 3 IVF cycles per lifetimeMD Code, Insurance §15-810
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ME
Maine
Limited Mandate
IVF covered — no specific cycle limit in statute (verify per plan)24-A M.R.S. §2764
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NH
New Hampshire
Limited Mandate
Infertility treatment covered — IVF included; cycle limits set by individual plansRSA 415:18-a
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DE
Delaware
Limited Mandate
Infertility treatment covered including IVF — cycle limits per plan18 Del. C. §3566A
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AR
Arkansas
Limited Mandate
Up to 1 IVF attempt coveredArk. Code §23-99-414
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WV
West Virginia
Limited Mandate
Infertility treatment covered — IVF included; specific limits per planW. Va. Code §33-16-3a
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MN
Minnesota
Limited Mandate
IVF and infertility treatment covered — specific cycle limits per plan benefit designMinn. Stat. §62A.141
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HI
Hawaii
Limited Mandate
Infertility treatment covered — IVF included for qualifying patientsH.R.S. §431:10A-116.5
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LA
Louisiana
Limited Mandate
Limited — covers IVF with restrictions on embryo creation and useLa. R.S. §22:1036.1
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MI
Michigan
Limited Mandate
Michigan law requires coverage of infertility services on fully-insured plans but explicitly excludes IVF, surrogate motherhood, and elective sterilization reversalNo IVF mandate; MCL §500.3406s (limited infertility coverage)
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Why State Mandate Expertise Matters for Billing

A claim that gets paid in Massachusetts may get denied in Texas. A prior auth that works for a New Jersey patient will fail if submitted with the same documentation in a non-mandate state. State mandate expertise isn't optional — it's the difference between a clean claim and a 45-day delay.

EasyRCM billing specialists are trained on each state's mandate requirements, top payer protocols, and cycle limit tracking. We verify mandate eligibility at intake and build state-specific billing workflows for every practice we serve.

21
Mandate States
require fertility coverage
28%
Avg. Denial Rate
on first IVF claims in new mandate states
50+
Payers Tracked
state-specific payer protocols
1–6
Cycle Limit Range
IVF cycles across state mandates

Billing in a mandate state?

EasyRCM manages fertility billing across all 21 mandate states — from eligibility verification to denial appeals. Get a free review of your current state mandate billing workflow.

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