Abstract Objectives In this study, we estimate an ex ante cost–benefit analysis of a Utah law directed at improving early cytomegalovirus (CMV) detection. Study design We use a differential cost of treatment analysis for publicly insured CMV-infected infants detected by a statewide hearing-directed CMV screening program. Methods Utah government administrative data and multi-hospital accounting data are used to estimate and compare costs and benefits for the Utah infant population. Results If antiviral treatment succeeds in mitigating hearing loss for one infant per year, the public savings will offset the public costs incurred by screening and treatment. If antiviral treatment is not successful, the program represents a net cost, but may still have non-monetary benefits such as accelerated achievement of diagnostic milestones. Conclusions The CMV education and treatment program costs are modest and show potential for significant cost savings.