Insights

Coverage of Ultrasounds Required to Determine Gestational Age


On July 1, 2021, the Insurance Department issued INS 21-042-AB explaining that insurers must cover all necessary medical examinations, imaging studies and tests required to determine gestational age. This includes coverage of ultrasounds for purposes of determining gestational age. 

As background, House Bill 2 was signed into law on June 25, 2021, and requires healthcare providers to use an ultrasound to determine the gestational age of a fetus (in addition to performing other medical examinations considered reasonably necessary to accurately determine gestational age), among other requirements. Because determining the gestational age of a fetus is included as routine prenatal care, it is a covered service. 

While this guidance applies to insurers, employers should be aware of these developments and confirm with carriers (as applicable) that ultrasounds for purposes of determining gestational age are a covered service.

INS 21-042-AB »
House Bill 2 »