Cervical cancer screening: new billing regulations in Germany

The revised EBM (German Uniform Evaluation Standard) comes into force on April 1, 2020. Among others, the amendments made concern the billing of the services within the framework of early detection of cervical cancer. Also, the new fee order item (GOP) for the human papillomaviruses (HPV) genotyping service was added.

The new regulation outlines that doctors will be allowed to perform and bill for the clinical examination and diagnostic tests for early detection of cervical cancer on the same day of treatment. The previous billing exclusion will be removed.

Specifically, the changes will concern fee order item (GOP) 01760 “Examination for the early detection of cancer in women in accordance with section B. II. §§ 6 and 8 of the cancer screening guideline”, as well as the GOP 01764 “Assessment diagnostics in accordance with Part III. C. § 7 of the Guideline for Organized Cancer Screening Programs (oKFE-RL)”. Until now, these GOPs have not been calculated on the same day of treatment.

The Evaluation Committee also made adjustments to the human papillomaviruses (HPV) test for the early detection of cervical cancer with retroactive effect as from January 1, 2020. The background is a clarification by the Federal Joint Committee (G-BA), which will lead to an adjustment of the documentation requirements of the Institute for Quality Assurance and Transparency in Health Care (IQTIG).

Accordingly, the genotyping of HPV types 16, and 18 in the case of positive HPV detection within the scope of cervical cancer screening will no longer be a mandatory service within GOPs 01763 “Detection of human papillomaviruses according to Part III. C. § 6 of the Guideline for Organized Cancer Screening Programs (oKFERL)” and 01767 “Detection of human papillomaviruses according to Part III. C. § 7 of the Guideline for Organized Cancer Screening Programs (oKFERL)”. The HPV genotyping service will now be provided via a new GOP 01769 paid extrabudgetary.

The full details in German can be found here. The corresponding Evaluation Committee decisions can be found here and here.

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