Cost-effective reimbursement analysis for medical technologies in Europe
Procedure coding, payment mechanism, reimbursement tariffs, policy, and HTA considerations in 20 EU countries
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The 2025 DRG (LKF) model announced in Austria
On June 26, 2024, the document "Changes and innovations in the 2025 LKF model" (Änderungen und Neuerungen in den LKF-Modellen 2025) was published. The document summarizes the most significant changes and innovations in the LKF model for inpatient and outpatient care. The newly added procedure codes mainly concern e-health, interventional radiology, pulmonary and airways, and surgical procedures fields.
For 2025, the main changes are planned to include the addition of 32 new procedure codes, the introduction of three procedure codes for billing in the day-case settings, the addition of five new ambulatory DRGs, an update of cases flat rates, adjustments of the cases daily and procedural components calculation and re-evaluation of the length of stay indicators.
In the current update, a specific focus is given to incentivizing the provision of services in day case and outpatient settings with significant changes in the calculations approach, resulting in increasing the tariffs of the respective DRGs.
The 2025 model will enter into force on January 1, 2025.
Some examples of the introduced procedure codes are listed below:
- AZ510 Telemedical control of a pulse generator for neuromodulation/deep brain stimulation (LE=per session);
- EQ550 Imaging-guided percutaneous embolization of venous and lymphatic malformations (LE=per session);
- FC015 Removal of individual lymph nodes without marking (LE=per session);
- GE080 Tracheotomy – open (LE = per session);
- LM130 Surgical reconstruction of complex acquired defects of the abdominal wall (LE=per session).
Also, one new provisional code (NUB) is planned to be introduced: code XN060 “Catheter ablation of the renal sympathetic nerve plexus (LE=per session)”.
The full details in German can be found here.
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