Further extension of the Hybrid DRGs catalog in 2026 agreed upon in Germany

On April 30, 2025, the National Association of Statutory Health Insurance Physicians (KBV) announced that it had reached an agreement with the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) on the further expansion of the Hybrid DRG catalog in 2026. The decision was made by the extended Evaluation Committee, as no consensus could be reached with the German Hospital Federation (DKG).

The Institute for the Hospital Remuneration System (InEK) and the Institute of the Evaluation Committee will now calculate Hybrid DRGs for the newly selected OPS (procedure) codes.

The key changes include:

• The Hybrid DRG model will now apply to hospital stays of up to two days;
• The list of procedures eligible for Hybrid DRGs will be expanded to include diagnostic and therapeutic coronary interventions, electrophysiological cardiac procedures, including ablation, surgical interventions involving pacemakers and defibrillators, laparoscopic cholecystectomy and appendectomy, further hernia repair procedures, percutaneous transluminal vascular interventions, and fracture repositioning.

Introduced in 2024 under §115f SGB V, the Hybrid DRG reimbursement model aims to promote outpatient surgery in Germany by incentivizing the shift of appropriate procedures from inpatient to outpatient (day case) settings. It focuses on interventions that, compared to international practices, are still predominantly performed on an inpatient basis in Germany despite proven safety and efficacy in outpatient (day case) settings.

The full details in German can be found here.

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