Belgium

In February 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the completion of a pilot project for gene expression profiling (GEP) tests in early-stage breast cancer, which ran from 2019. The pilot showed significant benefits, and INAMI-RIZIV launched a reimbursement for certain tests under the specific agreement (GEP convention) with healthcare providers.

On January 09, 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published 2023 tariffs for the “low variability care” (APR-DRG) system. APR-DRG logic for 2023 is not published as of January 27, so no information about its changes or new DRGs is available.

The Belgian healthcare system is gradually moving from a disease-management approach to a more person-centered integrated care approach. On December 19, 2022, the National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the extension of funding for integrated care pilot projects for the next two years. These projects are carried out in the context of a new inter-federal plan for integrated care.

Rehabilitation before or after a primary knee or hip replacement using a health app is temporarily reimbursed in Belgium under a specific agreement with the National Institute for Health and Disability Insurance (INAMI-RIZIV). Reimbursement was limited to patients participating in the clinical study. From October 01, 2022, all patients eligible for rehabilitation before and after a primary knee or hip replacement will receive it using a health app in combination with a certain minimum number of classic face-to-face physiotherapy sessions. Certain health apps must be included in the list of reimbursable mobile applications. For now, only one app (MoveUP Coach) is included.

On August 01, 2022, Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) launched a new reimbursement framework for remote medical consultations. The Nomenclature was changed accordingly: a new article 37, “Remote care,” was introduced with four new codes and fees for video and telephone consultations by physicians.

In July 2022, Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the extension of temporary reimbursement for gene expression profile (GEP) testing for early-stage breast cancer detection until December 31, 2022, and for molecular biology tests by next-generation sequencing (NGS) until June 30, 2023.

On June 17, 2022, INAMI announced the launch of a new reimbursement framework for remote medical consultations from August 01, 2022. The reimbursement for remote consultations was first introduced during the COVID-19 crisis via "teleconsultation" codes, which will now be terminated and replaced by other Nomenclature codes for telephone and video consultations. Physicians will receive a higher fee for video consultations.

On June 01, 2022, the National Institute for Health and Disability Insurance (INAMI-RIZIV) updated tariffs for the APR-DRG system. No changes in DRG logic were made, and no new DRGs were implemented.

On May 25, 2022, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published an updated List of reimbursable devices that came into force on June 01, 2022. A total of 12 new codes with the corresponding conditions of reimbursement were added to the List, which concerned sacral neurostimulation in fecal incontinence treatment, soft tissue markers, and osteosynthesis devices.

MoveUP is the first digital health app that has reached the level 3 level on the Mhealth validation pyramid. This means that the app is now reimbursed in Belgium.

The Belgian Health Care Knowledge Center (KCE) initiated a study aimed at defining a clear and transparent procedure for the evaluation of digital health technologies in Belgium.

A new temporary reimbursement framework for remote consultations is planned to be implemented in Belgium in spring 2022.