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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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The new ambulatory tariff structure will be submitted soon to the Swiss Federal Council

The outpatient medical services are currently billed via TARMED, which includes all the benefits of compulsory health insurance. TARMED is an outdated structure; Thus, curafutura, an association of health insurance companies in Switzerland, started the initiative to change the current outpatient pricing structure (TARMED) in 2016.

Ats-tms SA was founded at the beginning of 2016 by curafutura, the Federation of Swiss physicians (FMH), the association of Swiss hospitals (H+, who left ats-tms SA after the validation of benefit structure) and the medical tariff commission (MTK/CTM) in order to develop a thoroughly revised tariff structure for ambulatory medical benefits and to be able to update it regularly.

The new structure represents the services provided as an outpatient procedure and includes about 2800 positions spread over 70 chapters and divided according to the regions of the body. It is already available to the public and can be seen here.

In late 2018, curafutura let the public know that the new tariff structure for ambulatory medical benefits is almost ready to be submitted to the Federal Council.

See the full report in Italian here.

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