S Codes — Mandate Payers
S4016
Frozen Embryo Transfer Cycle (S Code)
Frozen embryo transfer (FET) cycle case rate — used by mandate payers and FBMs to track FET cycle utilization. Submitted alongside CPT code 58976 for covered FET cycles.
Billing Notes
S4016 is the FET cycle equivalent of S4011 (fresh IVF cycle). S4017 is used for cancelled FET (embryos thawed but transfer not performed). S4018 is for cancelled FET with no embryo thaw.
Diagnosis Codes
N97.x (infertility), Z31.61 (ART encounter)
Common Denial Reasons
- S4016 missing — FET claim rejected for missing S code
- S4016 vs S4017 selection error (completed vs. cancelled FET)
- Submitted to payer that does not require S codes
Payer Notes
Confirm whether the FET required a separate authorization from the original IVF cycle. Some payers issue a single auth for a fresh cycle + FET; others require separate FET auth.
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