- Confirm the patient is receiving an eligible Assisted Reproductive Technology (ART) treatment by the Eligible Provider, which for the purpose of this program has the meaning given to it in the RTAC Australia & New Zealand Code of Practice, which at the time of publishing this Checklist is:
- clinical treatments; counselling services; and laboratory procedures for the assessment and preparation of human oocytes, sperm or embryos and includes in vitro fertilisation; gamete intrafallopian transfer; intracytoplasmic sperm injection; embryo or gamete cryopreservation; surgical sperm recovery; oocyte, semen or embryo donation; embryo biopsy or non-invasive sampling for preimplantation genetic testing; gestational and traditional surrogacy and intrauterine insemination and also includes:
- the storage of gametes and embryos for use in ART,
- the obtaining of a gamete from a gamete provider for use in ART or for research in connection with ART, and
- treatments determined by an ART Provider to be performed for the purposes of an ART treatment.
- Confirm that the patient has incurred an eligible out-of-pocket expense associated with ART treatment as defined above
- Confirm that the patient is receiving treatment from the Eligible Provider, that is:
- certified to deliver the ART treatment by the Reproductive Technology Accreditation Committee (“RTAC”) of the Fertility Society of Australia and New Zealand, in accordance with the RTAC Australia and New Zealand Code of Practice, and
- authorised to operate in Australia
- Confirm that the patient has undergone an ART treatment with the Eligible Provider on or after 19 February 2025 but before 30 August 2028.
- Confirm that the patient is not claiming the Fertility Treatment Rebate for any of the following ineligible costs:
- any component of cost for ART treatment that has already been reimbursed by another government program or rebate, such as Medicare or the Fertility Treatment Rebate (for an ART Treatment received between 1 October 2022 and 18 February 2025),
- costs for treatments that are for the sole purpose of fertility preservation
- costs for treatments incurred from the publicly supported lower cost IVF programs at the following clinics:
- Fertility Unit at Royal Prince Alfred Hospital
- Westmead Fertility Centre linked with Westmead Hospital
- Fertility and Research Centre at the Royal Hospital for Women
- Acknowledge that Service NSW will use the information provided on this form to assess and manage the rebate. Service NSW will handle this information in line with their privacy collection notice linked on the Fertility Treatment Rebate Declaration Form.
- Advise the patient to check the Service NSW website to check they meet
income eligibility requirements.
Applicant
(People may receive fertility treatment but may not identify as a woman. The person seeking to become pregnant must lodge the claim)
The Declaration Form can only be submitted for the rebate by the Applicant. The Declaration Form must be accompanied by one receipt for out-of-pocket expenses incurred during fertility treatment.
The Applicant must confirm:
- they are a resident of NSW
- they have not previously claimed Fertility Treatment Rebate (for an ART treatment received between 1 October 2022 and 18 February 2025) or the Fertility Treatment Rebate -2 and/or has not had the rebate claimed on their behalf
- they were provided with ART treatment by the Eligible Provider on or after 19 February 2025 and incurred an out-of-pocket expense associated with that treatment.
- they meet the household income eligibility criteria as set out in the Policy Guidelines.
- the ART treatment provided was not:
- already reimbursed by another government program or rebate,
- for the sole purpose of fertility preservation,
- part of lower cost fertility treatment provided at a publicly supported IVF clinic (as set out in the Policy Guidelines), or
- for male treatments
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Inform the Applicant that Service NSW will store the information provided on this form to assess and manage the rebate. Service NSW will handle this information in line with their privacy collection notice linked on the Fertility Treatment Rebate Declaration Form.
For further information on eligibility and identification enquiries, please visit https://www.service.nsw.gov.au/transaction/apply-for-the-fertility-treatment-rebate or Call Service NSW at 13 77 88 Monday to Friday between 7am and 7pm (Sydney time).
