CommercialCoverageMedium impact
Assisted Reproductive Technologies 4.01.05
Excellus BlueCross BlueShield·OB-GYN·Women's Health (Obstetrics & Gynecology)
Effective date
Apr 15, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their Assisted Reproductive Technologies policy effective April 15, 2026, establishing specific coverage criteria for IVF and artificial insemination, including age-based treatment requirements and cycle limitations. The policy also lists several investigational procedures that are not covered, including assisted embryo hatching and sperm DNA integrity tests.
Action Required
Before April 15, 2026: Billing team must update system to flag CPT codes 89253 (assisted embryo hatching) and 89251 (co-culture of embryos) as investigational/non-covered for Excellus BCBS members. Providers must verify patients meet specific age-based assisted insemination cycle requirements before proceeding with IVF authorization. Update encounter forms to include infertility diagnosis requirements per NYS Insurance Law §4303.