DBC explained

Diagnosis Treatment Combination

What is a DBC?

A DBC (Diagnosis Treatment Combination, Diagnose Behandel Combinatie) is an administrative method for invoicing appointments, tests and the associated treatment(s). This method ensures that healthcare costs are properly documented and transparent – for you, your healthcare provider and your health insurer.

Bundled care
When you receive care at one of our clinics, not every procedure is charged separately. Fertility care is paid for through DBC care products. You can think of these products as a single ‘package’ of care and treatments used for a particular care need, for example to become pregnant.

Explainer video
The video by the Dutch Healthcare Authority (NZa) explains simply how payment for care works. This also applies to Nij Clinics.

How does a DBC work?

A DBC bundles all the care associated with a diagnosis and the related treatment process into one DBC care product. You can think of it as a package of tests, consultations and treatments that often go together in a particular care pathway, such as IVF treatment. A single fee applies to such a DBC, based on the average cost of the entire treatment process.

Once the treatment has ended or the duration has expired, the DBC is closed and invoicing follows.

Duration
The duration of a DBC can vary and is not tied to a calendar year, as fertility treatment can continue into the next calendar year.

What types of DBC are there?

In fertility care, consultations/diagnostics and treatments are deliberately recorded in separate DBCs. This keeps different types of care separate, so that costs remain clear and easy to check.

F11 | Initial fertility assessment (female)
This DBC care pathway mainly covers consultations and (basic) diagnostics relating to a wish to have a child, such as intake and follow-up consultations and, where needed, ultrasound scans.
F12 | Initial fertility assessment (male)For the male partner, a separate F12 can be opened for medical history and tests, often including semen analysis and, where needed, additional laboratory/screening tests.
F21 | Treatments
This DBC is intended for all treatments and procedures that follow on from an F11/F12.

More information below.

DBCs explained

Below, we briefly explain the different DBCs (F11, F12 and F21) and what you can expect from each care pathway, including its duration and the care it covers.

F11 | Consultations & diagnostics (female)

What is F11?
F11 is the DBC care pathway for all contact moments involving explanation, guidance and diagnostics. In other words, it is about talking and testing, not about actual treatment. An F11 covers:

Consultations at the clinic (intake, results consultation, treatment plan, evaluation)
Telephone or video consultations
Tests associated with such a consultation, such as blood tests and ultrasound scans when they are part of the consultation/diagnostics

Treatment is not covered by F11, but by an F21.

Duration

A first F11 care pathway runs for 90 days.
If you then come back for a consultation or diagnostics, a follow-up F11 starts with a duration of 120 days.

F12 | Consultations & diagnostics (male)

What is F12?
F12 is the DBC care pathway for all contact moments and tests for the male partner involving explanation, guidance and diagnostics. In other words, it is about talking and testing, not about actual treatment. An F12 covers:

Consultations at the clinic (intake, results consultation, treatment plan, evaluation)
Telephone or video consultations
Any tests associated with such a consultation, such as semen analysis and/or blood tests.

Duration

A first F12 care pathway runs for 90 days.
If you then come back for a consultation or diagnostics, a follow-up F12 starts with a duration of 120 days.

F21 | Treatments & procedures

What is F21?
When you start fertility treatment, we open an F21 DBC. This records all procedures that are part of a treatment, for example:

monitoring/ultrasound scans
an egg retrieval and laboratory phase,
or an insemination

Duration

An F21 DBC care pathway is closed per treatment cycle¹. In other words: when we start a new treatment cycle, the previous one is closed.
If no new treatment cycle¹ follows and the DBC is not closed manually, it closes after 42 days.

¹A treatment cycle is one complete round of treatment: from the start (medication and monitoring) up to and including completion (e.g. IUI or IVF). With a follow-up treatment, the DBC closes and a follow-up DBC is opened immediately.

When will you receive an invoice?

A DBC starts on the day of the first care, for example a first consultation or test. This start date is important, because it usually determines which health insurer and which year's compulsory deductible the costs are charged to (the year in which the DBC begins).

A DBC then remains open for a period (usually up to a maximum of 120 days) and is sometimes closed earlier, for example after 42 days for a treatment cycle or after 90 days for a first care pathway. If the care lasts longer, the DBC closes and a new one is opened immediately for the follow-up. The invoice can only be sent once the DBC has been closed, which is why it can take several months before you receive the bill.

Example: If the DBC was opened in 2025, your health insurer (and compulsory deductible) for 2025 will be charged, even if the appointments and treatment continue into 2026. If a follow-up treatment is started (a new or follow-up DBC opened) in 2026, your health insurer (and compulsory deductible) for that year will be charged.

Why are there DBCs?
DBCs were developed by the government to encourage market forces in healthcare. The current system partly makes this possible, because: treatment centres and health insurers can make agreements with each other about both the prices and the quality of treatments, from which patients can ultimately benefit; and there is more insight into what specific treatments cost. This allows treatment centres to organise their processes and organisation better, so that they can continue to offer affordable, efficient and effective care.

FAQ

Frequently asked questions

You will find the answers to our frequently asked questions alongside.
Can't find your answer? Please feel free to contact us.

FAQ Contact Register

Is the duration of a DBC tied to a calendar year?

A DBC is not tied to a calendar year. The duration of the DBC depends on the treatment processes required. This means that a DBC covering a fertility treatment, for example, can continue into the next calendar year.

Why are DBCs used?

To a certain extent, the government wants to encourage market forces in healthcare. The DBC system was developed to register and bill care in the Netherlands in a clear, fair and comparable way. This DBC registration method is mandatory nationwide.

The DBC system ensures transparency and efficiency in the care process. It helps both healthcare providers and insurers to register treatments properly, calculate costs and align reimbursements. Working with DBCs means that treatments can be invoiced more clearly and that there is transparent record-keeping of the medical care provided.

What information does a DBC care product contain?

A DBC care product includes, among other things:

Diagnosis: The medical condition you have.
Treatment plan: The treatments you undergo.
Duration: How long the treatment lasts (such as 90 days for F11 or 120 days for a follow-up treatment, or 42 days for F21 if no new treatment follows).
Costs: The costs charged for the treatment.

Core values

What makes us unique maakt

Personal

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Effective

We use the most advanced techniques and specialise in all forms of fertility treatment.

Experience

All our staff are experienced professionals who keep fully up to date with the latest developments.