2021 version of the EBM catalog published in Germany

The revised EBM (German Uniform Evaluation Standard) catalog came into force on January 1, 2021. MTRC has compiled the selection of the most significant changes.

The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalog (Einheitlicher Bewertungsmaßstab), updated once a quarter (4 times a year). The adaption time frame of the EBM catalog for a specific code is around five years but varies depending on the evidence.

The most important change is that the EBM reimbursement base rate (Orientierungswert) was increased from 10.9871 cents to 11.1244 cents: this increases the prices for all medical and psychotherapeutic services by 1.25%.

Next, large mutation searches in tumor and human genetics no longer have to be approved by the sickness funds since January 1, 2021. The services for human and tumor genetic mutation searches over 25 kilobases were integrated into the relevant fee order items. Also, the funding for human genetic in-vitro diagnostics was increased.

The EBM chapter 25 "Radiotherapy fee order items" was restructured and updated:

• The billing of the fee order item (GOP) 25321 "Radiation therapy with a linear accelerator in malignant diseases or processes involving masses in the central nervous system" has changed from "per fraction" to "for the first target volume, for each radiotherapy session".
• The following services were included in the EBM:
  • 25316 "Radiation therapy with a linear accelerator in benign diseases, for the first target volume, for each radiotherapy session" with a tariff of €45.05
  • 25317 "Surcharge for fee order item 25316 for radiation therapy of more than one target volume, for further target volumes, for each radiotherapy session" with a tariff of €25.59
  • 25318 "Surcharge for fee order item 25316 for image-guided radiation therapy (IGRT), for radiotherapy series" with a tariff of €35.15
  • 25324 "Surcharge for fee order item 25321 for radiation therapy of more than one target volume, for each additional target volume, for each radiotherapy session" with a tariff of €31.93
  • 25325 "Surcharge for fee order item 25321 for radiation therapy using high-precision technology, for radiotherapy series" with a tariff of €30.93
  • 25326 "Surcharge for fee schedule item 25321 for image-guided radiation therapy (IGRT), for radiotherapy series" with a tariff of €58.29
  • 25327 "Surcharge for fee order item 25321 for radiation therapy using high-precision technology in combination with image-guided radiation therapy (IGRT), for radiotherapy series" with a tariff of €82.99
  • 25328 "Surcharge for fee order item 25321 if the single dose ≥2.5 Gy is exceeded, for radiotherapy series" with a tariff of €64.19
  • 25329 "Surcharge for fee order item 25321 for radiation therapy of newborns, infants, toddlers, and children, for radiotherapy series" with a tariff of €34.82
• The material costs are now mapped by the radiotherapy services of the EBM chapter 25 and not reimbursed via additional fee order items anymore.

The full details in German can be found here.

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