Submitting Claims for Infertility Services

August 8, 2023

When completing claims for infertility services rendered to a surrogate or from a donor, please indicate the recipient on the claim form. Coverage for surrogates and donors may vary by plan. Inclusion of the recipient information on submitted claims will help us to expedite the proper processing of claims for these services.

How to indicate recipient: Simply add “surrogate” or “donor” to the comments or notes field on the claim form. For example:

  • On the UB-04 form, add “surrogate” or “donor” to Form Field 80 Remarks
  • On the CMS-1500 claim form, add “surrogate” or “donor” to Form Field 19 Additional Claim Information.