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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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Expansion of outpatient surgeries announced in Germany

On June 23, 2022, the National Association of Statutory Health Insurance Physicians (KBV) announced the first steps aimed to expand the utilization of surgical procedures within day case/outpatient settings (reimbursed via the German Uniform Evaluation Standard (EBM) catalog).

In the first stage, additional funding of around 60 million euros will be available from January 1, 2023, leading to an increase of the tariffs of the selected surgical procedures by about 30%. The aim is to incentivize the provision of these services on a day case/outpatient basis instead of within the hospital settings.

In a subsequent stage, the KBV and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) are planning to expand the calculation foundation for reimbursement for all day case/outpatient surgical procedures.

Also, currently, there are consultations ongoing concerning the expansion of the AOP catalog, which lists the day case/outpatient surgical procedures with conditions of their provision.

The full details in German can be found here.

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