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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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Dutch Healthcare Authority published the third release of the DRG package for 2021

On November 5, 2020, the Dutch Healthcare Authority (NZa) published the third release of the DRG package for the 2021 (RZ21c) to implement reimbursement for extra beds in intensive care and added the pathway for new optional add-on services.

The Ministry of Health, Welfare and Sport (VWS) has established a subsidy scheme for the accelerated expansion of the national capacity of IC bed. The NZa added two additional add-on services with a reduced tariff of €0.01 for the registration of IC days if the regular capacity of IC beds is exceeded:

  • 190159 IC day, VWS subsidy upscaling phase 2;
  • 190160 IC day, VWS subsidy upscaling phase 3.

By 2021, healthcare providers and health insurers can jointly apply for an optional service for specialist medical care from the Dutch Healthcare Authority (NZa). These services have a fast application procedure and can be implemented during the year. In the RZ21c release of the DRG package, the NZa implemented two types of optional services with specific procedure codes:

  • Regular optional supplementary services (codes 198500-198699): these services can be provided independently of other care, separately from DRG. It offers a free form for reimbursement of care when no DRG care pathway has been opened.
  • Optional add-ons (codes 198700-198799): for these services, additional reimbursement (for example, incurred in an innovation) can be obtained in addition to the DRG tariff. The add-on service always belongs to the DRG care pathway.

The full details in Dutch can be found here.

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