MedicaidCoverageMedium impact
Updates to Medicaid Coverage of Fertility Preservation Services for Iatrogenic Infertility, Effective October 7, 2023
Maryland Medicaid·MD · OB-GYN, Oncology, Radiation Oncology +2 more·Provider Transmittal
Effective date
Oct 7, 2023
We identified it
Jun 20, 2026
Summary
Effective October 7, 2023, Maryland Medicaid now covers fertility preservation services for patients with iatrogenic infertility (caused by surgery, radiation, chemotherapy, gender-affirming treatments, or other medical interventions). Billing teams must obtain prior authorization using updated clinical guidance and CPT codes with new reimbursement rates available through the provided link. This policy supersedes previous guidance in PT 34-24.
Action Required
By December 31, 2023: Billing and clinical teams must (1) access the updated CPT code list and reimbursement rates at https://bit.ly/3RjYmKC, (2) implement prior authorization requirements for all fertility preservation services in the billing system using the provided templates and clinical guidance, (3) train providers and front desk staff on the new coverage criteria for iatrogenic infertility, and (4) ensure encounter forms and authorization workflows reflect that these services now require preauthorization. Failure to obtain prior authorization will result in claim denials. Direct any questions to mdh.healthchoiceprovider@maryland.gov. Monitor the Preauthorization Information webpage (https://health.maryland.gov/mmcp/Pages/Preauthorization-Information.aspx) for future updates to clinical criteria and rates.