Reimbursement

In April 2025, the French National Authority for Health (HAS) opened the application period for including medical procedures and in-vitro diagnostic tests in its 2026 evaluation working program. The application deadline is July 8, 2025.

On April 30, 2025, the Federal Council approved the new outpatient reimbursement system, comprising the TARDOC catalog of individual service tariffs (ambulatory settings) and the flat-rate system (day case settings). The approval is valid until December 31, 2028, allowing for potential adjustments post-implementation. The TARDOC and outpatient flat rates will take effect on January 1, 2026.

On May 01, 2025, the Dutch Healthcare Authority (NZa) published the first release of the 2026 DRG package (RZ26a). Three new procedure codes, seven new supplementary payments (OZPs), one new diagnosis code, and two new DRGs will be implemented across in-vitro diagnostics, obstetrics and gynecology, neurology and neurosurgery, cardiovascular and other technology groups.

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 French National Authority for Health (HAS) released new recommendations regarding add-on the registration of reimbursement for medical devices and medical aids in the List of Reimbursable Products and Services (LPPR) following the April 2025 meetings of the National Commission for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Eleven favorable opinions were published concerning the registration of new devices or modifying conditions/indications for existing ones in the LPPR List. The recommendations relate to devices in the fields of endocrine, e-health, neuromodulation, peripheral vascular, and medical aids.

On March 19, 2025, the Ministry of Labor, Health, Solidarity and Families published the Decree establishing a regulatory framework for the restoration and traceability of medical devices for individual use. It mandates that only certified centers may perform refurbishment, introduces a national registry for tracking restored devices, and links LPPR reimbursement to compliance with restorability criteria (pending further specification of applicable device categories).

On April 1, 2025, the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) published its report on the utilization and development of digital health applications (DiGA) covering the period from September 1, 2020, to December 31, 2024. The report presents GKV’s key findings along with recommendations aimed at optimizing the current framework for DiGA reimbursement and regulation.

On April 9, 2025, the Ministry of Labor, Health, Solidarity and Families published the Order setting DRG tariffs and tariffs for other packages and supplements for 2025. New tariffs are applicable from March 1, 2025.

On April 8, 2025, the National Union of Health Insurance Funds issued an update to the Common Classification of Medical Procedures (CCAM), which serves as a reimbursement nomenclature for medical procedures in hospital and ambulatory settings. Changes include the introduction of new procedure codes, provisional registration of several procedure codes, and modification of existing services. Newly introduced procedure codes concern cardiovascular and peripheral vascular procedures, interventional radiology, ENT, and others. The update takes effect on July 1, 2025.

In March 2025, the entity managing the DRG system in Switzerland, SwissDRG, announced that they would be accepting applications for changes in the DRG system from June 2, 2025, until July 14, 2025. The results of the DRG applications made in 2025 will be reflected in the 2027 version of the SwissDRG.

On April 1, 2025, the revised EBM (German Uniform Evaluation Standard) catalog for the second quarter of 2025 came into force. The main changes introduced concern updates of the contents (services legends, preambles of several EBM subchapters) and the introduction of new EBM codes related to follow-up and evaluation of another reimbursable health app and second-opinion consultations.

The French National Authority for Health (HAS) has released new recommendations regarding add-on reimbursement for medical devices and medical aids following the March 2025 meetings of the National Commission for the Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Six favorable opinions were published concerning the registration of new devices or modifying conditions/indications for existing ones in the List of Reimbursable Products and Services (LPPR). The recommendations relate to devices in the fields of cardiovascular, peripheral vascular, endocrine, neuromodulation, and medical aids.