Gastrointestinal endoscopy

On April 4, 2025, NHS England published the final NHS Payment Scheme (NHSPS) for the 2025/26 financial year (starting on April 1st), defining payment mechanisms for the provision of NHS-funded hospital and ambulatory care and some public health services. No significant changes were made to the general payment model. The key changes include the introduction of reimbursement for activities from Community Diagnostic Centres and a new Best Practice Tariff to incentivize shifting suitable procedures from day case/hospital to outpatient settings.

In February 2025, the HTA body of Tuscany Regional Healthcare published four new rapid HTA reports on medical devices used in cardiovascular, endoscopy, pulmonology, and general surgical fields.

On October 26, 2023, the BfArM (Federal Institute for Drugs and Medical Devices) published the final version of the 2024 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care in Germany.

On August 11, 2024, the BfArM (Federal Institute for Drugs and Medical Devices) published the preliminary version of the 2024 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in inpatient and outpatient care in Germany.

In mid-December 2022, the Danish Health Data Agency (Sundhedsdatastyrelsen) published an update of the Health Care Classification System (Sundheds-væsenets Klassifikations System, SKS). The most significant changes include: 11 new diagnosis codes, 27 new procedure codes, and eight additional codes (Tillægskoder) were added. The newly added procedure codes mainly concern the obstetrics and gynecology, surgical procedures, endocrine, gastrointestinal, and radiology fields, and some other technology groups.

On May 31, 2022, the French National Authority for Health (HAS) published the final positive opinion on the coverage of the endoscopic gastroplasty with the ENDOMINA triangulation platform under the Innovation package (Forfait innovation).

On December 9, 2021, the Danish Treatment Council (Behandlingsråd), during its meeting, approved three topics selected for developing the so-called major analyses (større analyser) in 2022. The approved topics include handheld focused ultrasound in emergency medicine, artificial intelligence (AI) as decision support for colonoscopy, and intelligent/high-tech beds for use in intensive care units.

In late October 2021, the Treatment Council (Behandlingsråd) published three topics chosen for developing the so-called major analyses (større analyser) in 2022. The selected topics include patient-centered diabetes technology, hand-held focused ultrasound in emergency medicine, and artificial intelligence as decision support for colonoscopy.

In late October 2021, the BfArM (Federal Institute for Drugs and Medical Devices) has published the final version of the 2022 OPS procedure coding classification. The OPS, together with the ICD-10-GM (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification), forms the basis for the reimbursement systems in outpatient and inpatient care.

In March 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0175 and 0072 with changes to be implemented not later than May 01, 2021. Six new procedure codes related to gynecology, capsule endoscopy, and intracranial stereotactic radiotherapy were introduced. No changes were made in diagnostic test coding.

In late September 2020, the Austrian version of the DRG system (LKF) 2021 model with the relevant supplementary documents was published in Austria. For 2021, the main changes include the addition of sixteen new procedure codes and the introduction of two new procedure codes for billing in the day-case settings, update of cases flat rates, and adjustments of the cases daily component calculation.

MTRC has developed three reports on the key market access topics, including innovation funding, health technology assessment and funding frameworks for medical devices. These reports help to understand the relevance of these frameworks to certain types of medical technologies, including gastrointestinal technologies. This post provides some key facts about the HTA, funding and innovation payment landscape for gastrointestinal devices in Europe.