IVF Program

Information for health professionals about the Pharmaceutical Benefits Scheme (PBS) subsidised section 100 In-Vitro Fertilisation (IVF) Program.

About the program

The IVF Program administration arrangements align with other PBS subsidised medicines through the use of a prescription. Medicines available under this program are listed as Authority Required (STREAMLINED) and can be dispensed from a patient’s choice of approved supplier:

  • community pharmacy
  • hospital pharmacy, or
  • dispensing doctor

Find out which medicines are available under the IVF Program on the PBS website.

For patient eligibility, patients must be receiving treatment as described in the below Medicare Benefits Schedule item codes.

Item Service
13200 Assisted reproductive technologies superovulated treatment cycle proceeding to oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13201, 13202, 13203, 13206 or 13218 applies, being services rendered during 1 treatment cycle - initial cycle in a single calendar year.
13201 Assisted reproductive technologies superovulated treatment cycle proceeding to oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones, ultrasound examinations, all treatment counselling and embryology laboratory services but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13200, 13202, 13203, 13206 or 13218 applies, being services rendered during 1 treatment cycle - each cycle after the 1st in a single calendar year.
13202 Assisted reproductive technologies superovulated treatment cycle that is cancelled before oocyte retrieval, involving the use of drugs to induce superovulation and including quantitative estimation of hormones and ultrasound examinations, but excluding artificial insemination, transfer of frozen embryos or donated embryos or ova or a service to which item 13200, 13201, 13203, 13206 or 13218 applies, being services rendered during 1 treatment cycle.
13203 Ovulation monitoring services for artificial insemination, including quantitative estimation of hormones and ultrasound examinations, being services rendered during 1 treatment cycle but excluding a service to which item 13200, 13201, 13202, 13206, 13212, 13215 or 13218 applies.

Approved prescriber information

Only eligible approved prescribers can prescribe IVF Program medicines. When prescribing medicines under this program you must:

  • use a PBS prescription form
  • include your Reproductive Technology Accreditation Committee (RTAC) accredited unit number on the prescription, available on the Fertility Society of Australia’s website, and
  • include the streamlined authority code on the prescription. You can search for the correct streamline authority code by searching the drug name on the PBS website

If you are prescribing increased quantities prior approval must be obtained.

You may obtain approval by:

Patient advice

We recommend you tell your patients that:

  • their prescription can be dispensed by an approved community pharmacy, hospital pharmacy or dispensing doctor of their choice, and
  • they will need to contribute towards the cost of the subsidised medicine at the pharmacy and their contribution goes towards their PBS Safety Net

Approved supplier information

PBS subsidised IVF medicines can be dispensed at an approved community, public or private hospital pharmacy and by dispensing doctors.

You will need to order S100 IVF medicines directly from the manufacturer or wholesaler to dispense.

Reimbursement for dispensing these medicines will align with the current process for supplying other PBS subsidised Highly Specialised Drugs (HSD). Reimbursement is calculated using ex-manufacturer pricing, not ex-wholesaler pricing.

Your pharmacy dispensing software will be required to capture all the relevant information to ensure the PBS subsidy and the patient’s PBS contribution is collected. From 1 July 2016, this includes the Reproductive Technology Accreditation Committee accredited unit number. This number is recorded by the prescriber on the prescription. PBS Reason codes for online claiming specific to the RTAC unit number will be effective from 1 July.

Further information

Read more about pricing of Pharmaceutical Benefits Scheme medicine, the streamlined authority process and the PBS Safety Net for patients.

Learn about writing PBS and RPBS prescriptions with our education guide for medical practitioners in private practice and who can use and order PBS and RPBS prescription forms.

Page last updated: 8 November 2016

This information was printed Wednesday 7 December 2016 from humanservices.gov.au/health-professionals/enablers/ivf-program It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.