The short answer
- US, with insurance or Medicare: FDA-approved products (Rebyota, Vowst) and conventional FMT for recurrent C. difficile are generally covered when medical criteria are met — your out-of-pocket cost is your plan's normal deductible/coinsurance.
- US, paying cash: list prices are high. Rebyota's list price is around $9,200 for a single 150 mL dose (Drugs.com price guide), before clinic and administration fees.
- UK: FMT for recurrent C. difficile is provided through the NHS under NICE guidance, so eligible patients do not pay per treatment.
- Investigational uses (ulcerative colitis, IBS, autism, depression and others) are generally not covered by insurance outside clinical trials.
US costs in detail
Since late 2022, two donor-stool products have full FDA approval for preventing recurrent C. difficile infection:
- Rebyota (fecal microbiota, live-jslm) — a single rectal dose given in a clinic. Its published cash price is roughly $9,200 per dose, and the clinic visit adds further charges.
- Vowst (fecal microbiota spores, live-brpk) — a short course of oral capsules dispensed through a specialty pharmacy. Pricing varies by pharmacy and insurance; the manufacturer runs a support program (VOWST Voyage) that verifies coverage and offers savings options.
Conventional colonoscopy-delivered FMT, when billed, combines the procedure fee, the stool bank's material charge, and facility fees — totals reported in the literature and by clinics typically run from the low thousands of dollars upward.
Medicare and private insurance
Medicare: Rebyota is covered under Part B as a physician-administered drug, so beneficiaries typically pay 20% coinsurance after the Part B deductible (often less with supplemental coverage). Vowst, as an oral drug, falls under Part D or Medicare Advantage drug plans, with costs depending on the plan's formulary. Conventional FMT procedures for recurrent CDI have been reimbursed by Medicare administrative contractors when documentation criteria are met.
Private insurance: most major payers now have written medical policies covering FMT — and the approved products — for multiply-recurrent C. difficile, usually requiring documented recurrence after antibiotic therapy. Coverage for any other condition remains rare, because those uses are still investigational.
Practical steps: ask your insurer for the written medical policy on "fecal microbiota transplantation", confirm prior-authorization requirements, and check manufacturer assistance programs if cost is a barrier.
UK costs
NICE guidance recommends FMT for adults with recurrent C. difficile who have had two or more episodes, and treatment is delivered through NHS hospital trusts using screened donor material. For eligible NHS patients there is no per-treatment charge. Private clinics offering FMT for other conditions exist, but these uses sit outside NICE recommendations and are self-funded — prices vary and claims should be weighed carefully against the evidence.
Frequently asked questions
Does insurance cover FMT for ulcerative colitis or IBS?
Generally no — these remain investigational, and treatment is usually only available free of charge inside registered clinical trials.
Is there financial assistance for Rebyota or Vowst?
Yes — both manufacturers operate patient support programs that can verify coverage and, for eligible patients, reduce out-of-pocket costs. Your prescriber's office can start enrollment.
Why is it so expensive if the raw material is stool?
The price reflects donor screening, pathogen testing, controlled manufacturing, regulatory compliance, and cold-chain distribution — not the raw material.
Sources and further reading
- Drugs.com — Rebyota price guide
- VOWST Voyage — manufacturer savings & support program
- NICE MTG71 — FMT for recurrent C. difficile infection
Related: FMT for recurrent C. difficile · How FMT works · All conditions