2024 Norwegian Pathology Activity Codes (APAT) and reimbursement tariffs released

In December 2023, the reimbursement scheme for outpatient pathology services was updated for 2024. This scheme has been gradually introduced in Norway since 2022. It comprises fee-for-service reimbursement by Helfo (the Norwegian Health Economics Administration, an external agency of the Directorate of Health) using Pathology Activity Codes (APAT) of the Norwegian Pathology Code system (NORPAT). Previously, NORPAT was not used for reimbursement, and tariffs from the Ministry of Health and Care Services were used for a limited number of pathology procedures.

APAT codes (and NORPAT) are updated annually and published by the Directorate of e-Health (merged with the Directorate of Health on January 1, 2024). In the new scheme, Helfo annually publishes the list of reimbursable APAT codes (for public and private laboratories). Each code is allocated to a generic reimbursement category. Tariffs for reimbursement categories (for public and private laboratories) are published annually by the Ministry of Health and Care Services and on the Directorate of e-Health website. 

The following codes are used in APAT:

• T-codes for sampling materials, which are not allocated to reimbursement categories; 
• P-codes for the method of sampling, indications, and method of testing. Some P-codes are allocated to reimbursement categories (so-called ‘additional’ P-codes) and, therefore, allow additional payment, while others are not;
• ‘Classified sample materials’ are the specific combinations of T- and P-codes that are allocated to the reimbursement categories.

In 2024, five new ‘additional’ P-codes were included in the reimbursement scheme. Some examples are presented below.

• P33451 “DNA sanger sequencing, exons” was allocated to reimbursement category PATA7 (reimbursement tariff in state laboratories is 850.18 NOK);
• P33712 “DNA next generation sequencing (NGS) whole genome” was allocated to reimbursement category PATA12 (the reimbursement tariff in state laboratories is 18953.66 NOK).

In 2024, nine new classified sample materials for cytology and histology were introduced. Some examples of new codes are provided below:

• TX2000 brain + P31070 imprinting study, with reimbursement category PATP1 (the reimbursement tariff in state laboratories is 116.9 NOK);
• T87800 both ovaries + P11004 resection, prophylactic, with reimbursement category PATP6 (the reimbursement tariff in state laboratories is 1290.14).

See the full details in Norwegian here (codes), here (tariffs), and here (reimbursement by Helfo). 

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