Bioidentical hormones are hormones that are created to be the same as your body made before menopause. They are synthesized from plant substances and are made to be like your body's natural hormones. The pharmacies that make (or supply) them are called compounding pharmacies. Some women will benefit from hormones given at low doses that are not commercially available at regular pharmacies so we have them made up by special compounding pharmacies.
Saliva testing may be helpful in managing menopause, PMS and hormone imbalances. Peripheral (saliva) levels of hormones may help guide the management of symptoms and be more reflective of actual tissue levels vs. blood levels which may come back normal yet the tissue levels are low. The cost for the saliva testing will range from $175 to $315, depending on which hormone levels we recommend be tested, according to your symptoms. Most insurance companies do not cover the cost so we will not submit the cost of the testing to the insurance carriers; rather, you must pay for the testing when we provide you with the test kit. It is then UP TO YOU TO SEND IN THE RECEIPTS AND CODES and get reimbursed directly by your carrier. Follow up tests after treatment, one to two times per year may be all that is necessary after the initial comprehensive assessment. We have provided you with the codes for each panel type. 
If we decide based on your symptoms that you need compounded prescriptions, we work with several very reputable compounding pharmacies, including The Healthy Choice Pharmacy in Chappaqua, NY, and Madison Pharmacy in Wisconsin. Based on the results of your saliva tests, we have them custom make your prescription. They can make creams, pills, or various other forms and can mix and match things for you. The FDA does not approve many compounded hormone combinations nor regulate these pharmacies. However, we have had excellent experience with both pharmacies for decades. Beware, however, that all hormones are synthetic and even low dose bioidentical hormones can carry risks (DVT, stroke, estrogen sensitive cancers, etc). We believe these risks are minimized by the use of the RIGHT choices, low doses, made just for you.
Your insurance may or may not cover compounded hormones. Some local pharmacies such as Kinney Drugs in Watertown, Kinney Drugs in Camden, or The Medicine Shoppe in Camillus, will do this service for you. YOU are responsible for the cost if your insurance won't pay. We have a generic letter for you to use but we DO NOT TAKE RESPONSIBILITY to get them approved. They are optional.
There are FDA approved bioidentical hormones available at regular pharmacies such as Prometrium and estradiol. They are a more "one size fits all" but may work fine for you. We can not guarantee any coverage. It has been our experience that often the compounded combo prescriptions are the same cost as co-pays for your regular prescriptions!!!
We will likely have a minimum of 3 appointments with you to provide you with this service. It is not available at most gyn offices. It takes time and special prescriptions. We may not be able to refill or adjust your prescriptions unless we see you in the office or require additional follow up saliva testing. If we call you because you can not come in or live far away, we will charge a fee for the phone consult.

The following CPT codes are to be submitted for saliva testing.
Comprehensive Panel Plus: 12345, 82670, 12345, 84144, 84402, 82626, 82530 (x4)
Comprehensive Panel: 82670, 84144, 84402, 82626, 82530 (x 4)
Short Comprehensive Panel: 82670, 84144, 84402, 82626, 82530 (x2)
Basic Panel: 82670, 84144, 84402, 82626, 82530
Adrenal Function Panel: 82626, 82530 x 4
Cortisol Panel: 82530 x 4
Individual Hormone Tests:
Estradiol          82670                                      Progesterone   84144
Testosterone    84402                                      DHEA             82626
Cortisol           82530                                      NTX                82523
Diagnosis Code for all above to be 627.2 Menopausal symptoms
Resulting from the saliva testing, patient will then be given a prescription for a compounded prescription for bioidentical hormones to be filled by either The Healthy Choice Compounding Pharmacy or Madison Pharmacy.
Please note: these tests are NOT performed at/by our facility/office. Patients send them to Labrix for analysis.   1-877-656-9596. 

739 Irving Avenue - Suite 530 Syracuse, NY 13210 Tel: 315-478-1158 - Fax: 315-478-3014

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