Germany

On November 9, 2020, in accordance with §137h Paragraph 6 SGB V, the Federal Joint Committee (G-BA) has initiated an evaluation procedure for endovascular implantation of a stent-graft with valve element in tricuspid valve insufficiency within the framework of the early benefit assessment.

In late October 2020, the BfArM (Federal Institute for Drugs and Medical Devices) has published the final version of the OPS 2021 (Operation and Procedure Keys) system. 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 late October 2020, three more reimbursable health apps were introduced on the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM). These applications can be prescribed by physicians and psychotherapists and will be reimbursed by health insurers.

In mid-October 2020, the Federal Joint Committee (G-BA) has decided that three more biomarker-based tests in breast cancer will be covered by the statutory health insurance. Since January 2020, the "Oncotype DX Breast Recurrence Score" test is already reimbursed in Germany with a tariff of €3,296.50.

The revised EBM (German Uniform Evaluation Standard) catalog for ambulatory reimbursement in Germany came into force on October 1, 2020. MTRC has compiled the selection of the most significant changes, concerning In-vitro diagnostics, telemedicine and vacuum wounds therapy.

In early October 2020, the first reimbursable health apps were introduced on the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM). These applications can be prescribed by physicians and psychotherapists and will be reimbursed by health insurers.

In mid-August 2020, the German Federal Institute for Drugs and Medical Devices (BfArM) published the preliminary 2021 version of OPS procedure coding nomenclature. Numerous content updates and new procedure codes inclusion concern the chapters 1 “Diagnostic measures,” 5 “Operations,” and 8 “Non-operative therapeutic measures.” The list of new endoscopy-related procedure codes added under the respective OPS sub-chapters of chapters 1 and 5 is provided below:

From October 1, 2020, balneophototherapy can also be used for patients with moderate to severe neurodermatitis and billed via the EBM (German Uniform Evaluation Standard). So far, dermatologists have only been able to use the method for patients with psoriasis.

On behalf of the Federal Joint Committee (G-BA), the Institute for Quality and Efficiency in Health Care (IQWiG) investigated to what extent adults with symptomatic knee cartilage defect (but without advanced arthrosis) could benefit from autologous chondrocyte implantation (ACI) of different types: periosteal-covered (ACI-P), collagen-covered (ACI-C) or matrix-associated (M-ACI).

The Institute for Quality and Efficiency in Health Care (IQWiG) investigated the extent to which evidence is available for the benefit and harm of non-invasive computed tomography angiography (CTA) and stress diagnostics using magnetic resonance imaging (MRI) in people with suspected coronary heart disease (CAD) using evidence mapping.

The German Association for Digital Health Care (Spitzenverband Digitale Gesundheitsversorgung e.V.) published the list of companies that submitted applications for inclusion in the directory of digital health apps (DiGA) in the first phase.

On behalf of the Federal Joint Committee (G-BA), the Institute for Quality and Efficiency in Health Care (IQWiG) investigated whether (former) heavy smokers within statutory health insurance (SHI) should be offered lung cancer screening using low-dose computed tomography (LDCT).