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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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Expected changes in the German EBM catalog in 2023

On September 14, 2022, the Evaluation Committee published a preliminary (so-called announcement) decision on the further development of the German Uniform Evaluation Standard (EBM) catalog, which regulates the reimbursement of services in the public outpatient sector in Germany and is updated once a quarter (four times a year).

In 2023, as a part of the further development of the EBM catalog, additional funding of €60 million will be available to promote outpatient (day case) surgical services. It is expected that the tariffs of the relevant services under the EBM sub-chapters 31.2 and 36.2, as well as sterilization and abortion-related services, will be increased by about 30%. A decision on the specific details is expected to be published by the Evaluation Committee in mid-December 2022.

In parallel to the adjustments to outpatient operations in the EBM, consultations between the KBV, the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), and the German Hospital Federation (DKG) are also being held to expand the catalog for ambulatory operations in hospitals (AOP catalog). The goal is also to uniform the reimbursement of the services for hospital-employed and contracted physicians.

The full details in German can be found here and here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news).

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