This is somewhat uncharted territory for the IRS, so I would be conservative in my deduction. If your monthly payment is $1,000 and in return you get two free office visits per year, I would deduct the value of the free office visits rather than the $12,000 total. If your monthly fee is somewhat in line with the services you receive in return, I would be okay deducting the full amount. I've seen a lot of discussion on this, and the word "reasonable" is often used by the IRS.
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