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Home : IVM : Comparing Costs to IUI : Infertility Costs

Information on charges for infertility procedures

Medical care is charged for and paid for using procedure codes developed by the AMA.  Separately identifiable procedures are isolated and evaluated by committees of the AMA.  Their relative value compared to established codes is calculated and this information is standardized so that insurance companies can establish a rational price to pay for a code proportional to the “work” that goes into it. 

The system is far from perfect and at times does not feel equitable.  Codes are very slowly added and even more slowly deleted as the way doctors do things evolves.   At times things evolve so much that the codes can be far behind the practice of medicine.    IVF has been with us for more than 20 years, but it is only recently that there are codes which adequately describe some of the laboratory procedures that are done.  In reproductive technology, new things are constantly being developed and we appear to always be running behind.

A complex procedure (like most infertility therapies) is composed of diverse smaller procedures (e.g., an IUI involves a laboratory sperm preparation and a clinical intra-vaginal procedure) and a clinic performing an IUI would bill for both of these (although the intra-vaginal procedure itself is usually referred to as the IUI).   More complex procedures have more components and these components are likely to vary between institutions.  For example, one institution may view a particular lab test done in the context of a procedure as important and another one may not.   Procedure components get added and deleted as the practice of infertility evolves. 

Having different components, is one of that factors that makes it hard to compare prices between good institutions unless they offer a self pay package price and the components of that package are well defined.  Package prices can also different because of big things. For example, ICSI, a fertilization procedure that involves injecting a single sperm into an egg, used to be done only for severe male factor. Today it is used iN MORE THAN 60% of the IVF cases performed in the United States and Europe.  Our package prices all include ICSI which will be done in 80-90% of our patients.  We do assisted hatching on all patients over 35 years old, so our package price includes that also.  We are selective in terms of the embryo we recommend freezing and less than 20% of our patients have cryo-preservation, so it is excluded from most of our packages.

Our IVF packages include everything done in a routine IVF that is captured by a specific IVF code from the aspiration to the transfer.  It does not include IVF medications or the monitoring of the use of those medications.  Many people have coverage for either the medications or the monitoring.  If they don’t have coverage for the monitoring, we offer a package price which establishes a ceiling for the most that the monitoring could cost them. 

 

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