← All State Mandates|Comprehensive Mandate

Washington Fertility Billing
& IVF Mandate Guide

New comprehensive mandate covering IVF, IUI, egg freezing, and fertility medications — significant billing volume expansion

Statute
RCW 48.43.0128 (SB 5765)
Effective
January 1, 2024
Plans Covered
Fully-insured individual and group health plans

What's Covered Under Washington's Mandate

Up to 3 IVF cycles; unlimited IUI. Always verify individual plan benefit designs at patient intake.

IVF (standard cycles)
✓ Mandated

Up to 3 IVF cycles covered

IUI
✓ Mandated

Unlimited IUI cycles mandated

Egg freezing (oocyte cryopreservation)
✓ Mandated

Covered for fertility preservation

Embryo cryopreservation
✓ Mandated

Covered as part of IVF benefit

Fertility medications
✓ Mandated

Mandated to be covered as part of infertility treatment

ICSI
✓ Mandated

Covered when clinically indicated

Donor egg cycles
✗ Not Mandated

Not mandated — verify per plan

PGT
✗ Not Mandated

Not mandated — payer discretion

Self-funded employer plans (ERISA)
✗ Not Mandated

Exempt from WA state mandate

Washington Billing Notes

1
New mandate — payer policies still evolving

The WA mandate took effect January 1, 2024. Payer prior auth workflows and benefit designs are still being finalized. Verify current requirements with each payer quarterly.

2
Premera and Regence dominant

Premera Blue Cross and Regence BlueShield are the two dominant commercial payers in Washington. Both require prior authorization for IVF — submit clinical documentation at least 2–3 weeks before the planned start of stimulation.

3
Kaiser WA in-network only

Kaiser Permanente Washington is an HMO — IVF must be performed at an in-network Kaiser facility or with a Kaiser referral. Out-of-network ART claims will be denied.

4
Fertility drug billing

Washington mandates fertility drug coverage. Coordinate billing of injectables between the practice and pharmacy benefit. Some payers require the medications to be billed under the medical benefit with CPT supply codes.

Top Payers in Washington

Premera Blue Cross
Regence BlueShield
Kaiser Permanente WA
UnitedHealthcare
Aetna
Cigna

EasyRCM tip: Payer requirements change frequently. We track prior auth workflows, coverage criteria updates, and denial pattern shifts for every major payer in Washington — so you don't have to.

Washington Fertility Billing — FAQ

When did Washington's IVF mandate take effect?

Washington's fertility insurance mandate (SB 5765, RCW 48.43.0128) took effect January 1, 2024. Fertility practices in Washington should expect continued policy updates as payers finalize their benefit designs.

How many IVF cycles are covered in Washington?

Washington mandates up to 3 IVF cycles. Unlimited IUI cycles are also mandated, making Washington's law one of the more generous recent mandates.

Are fertility medications covered under Washington's mandate?

Yes. Washington mandates coverage for fertility medications as part of infertility treatment. This includes injectable stimulation medications and trigger shots used in IVF and IUI protocols.

Billing under Washington's mandate?

EasyRCM handles fertility billing for practices in Washington and all 21 mandate states — from eligibility verification and prior auth to denial appeals and A/R recovery.

Book Your Free WA Billing Review →