New out-patient reimbursement codes for prescription of health apps in Germany

30

Mar 2021

On March 17, 2021, the Evaluation Committee (Bewertungsausschuss) has decided to introduce two new EBM (German Uniform Evaluation Standard) codes related to health apps with retrospective effect from January 1, 2021.

The following codes will be introduced under the EBM sub-chapter 1.4 “Visits, the examination of home care, prescribing special treatment measures, administrative complex, telephone consultation, consult flat rate, stay”:

  • 01470 “Additional flat rate for issuing an initial prescription for a digital health application (DiGA) from the directory in accordance with Section 139e SGB V” (Zusatzpauschale für das Ausstellen einer Erstverordnung einer digitalen Gesundheitsanwendung (DiGA) aus dem Verzeichnis gemäß § 139e SGB V) with a value of 18 points (equal to approximately €2.00)
  • 01471 “Additional flat rate for the follow-up and the evaluation of the digital health application (DiGA) somnio” (Zusatzpauschale für die Verlaufskontrolle und die Auswertung der digitalen Gesundheitsanwendung (DiGA) somnio) with a value of 64 points (equal to approximately €7.12)

The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalog (Einheitlicher Bewertungsmaßstab), updated once a quarter (4 times a year). The updated EBM catalog for the second quarter of 2021 is expected to be available at the beginning of April 2021.

The full details in German can be found here.

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