Colorado Fertility Billing
& IVF Mandate Guide
Comprehensive 2024 mandate covering IVF, IUI, egg freezing, fertility drugs, and embryo storage
What's Covered Under Colorado's Mandate
Up to 3 IVF cycles; 6 IUI cycles. Always verify individual plan benefit designs at patient intake.
Up to 3 IVF cycles covered
Up to 6 IUI cycles covered
Fertility preservation covered
Covered including at least 1 year of storage
Mandated as part of infertility treatment
Covered when clinically indicated
Covered as part of IVF benefit
Not mandated — payer discretion
Exempt from CO state mandate
Colorado Billing Notes
Colorado's mandate took effect January 1, 2024. Payer benefit designs and prior auth requirements are still being finalized. Confirm current requirements with each payer before initiating a cycle.
Anthem BCBS Colorado requires prior authorization for IVF and typically reviews clinical documentation including diagnosis, AMH, AFC, and prior treatment history. Allow 2–3 weeks for auth processing.
Colorado mandates up to 6 IUI cycles. Track per patient — bill each IUI with CPT 58321 or 58322 and maintain a utilization log to prevent benefit exhaustion surprises.
Kaiser Permanente Colorado patients must receive ART services within the Kaiser system. Out-of-network IVF claims will be denied — verify Kaiser patients require internal referral.
Top Payers in Colorado
EasyRCM tip: Payer requirements change frequently. We track prior auth workflows, coverage criteria updates, and denial pattern shifts for every major payer in Colorado — so you don't have to.
Colorado Fertility Billing — FAQ
When did Colorado's IVF mandate start?
Colorado's fertility insurance mandate (SB 23-093) took effect January 1, 2024. It is one of the most recent comprehensive state mandates.
How many IVF and IUI cycles does Colorado cover?
Colorado mandates up to 3 IVF cycles and 6 IUI cycles per patient. Embryo storage for at least 1 year following retrieval is also mandated.
Does Colorado cover egg freezing?
Yes. Colorado's mandate includes coverage for oocyte cryopreservation (egg freezing) as part of fertility preservation. This applies to medically indicated cases.
Billing under Colorado's mandate?
EasyRCM handles fertility billing for practices in Colorado and all 21 mandate states — from eligibility verification and prior auth to denial appeals and A/R recovery.
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