Reimbursement

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.

In March 2025, two new versions of the Nomenclature of Medical Biology Procedures (NABM 95 and 96) were released. No new tests were added. The reimbursement tariffs for several existing tests were adjusted, and one test was removed.

On March 6, 2025, NHS England released an annual update of the HRG4+ Local Payment Grouper for 2025/26, to come into effect on April 1, 2025. No new HRGs were added; the total number of HRGs has not changed (2,900).

Between late February 2024 and early March 2025, seven more health apps were introduced in the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM) and thus became reimbursable. These apps can be prescribed by physicians and psychotherapists and will be reimbursed by health insurers. In total, 59 health apps are currently available in the DiGA Directory, and ten health apps were delisted from the Directory.

On February 18, 2025, the Swiss Health Observatory (Obsan) published its 2023 report confirming the ongoing shift from inpatient to outpatient care in Switzerland. The number of procedures required to be performed in outpatient settings to be reimbursed expanded from six in 2019 to 18 in 2023, with outpatient costs two to eight times lower. Despite the shift, overall healthcare costs have risen due to an increase in treatment volumes.

The French National Authority for Health (HAS) has released new recommendations about add-on reimbursement of medical devices and medical aids from the February 2025 meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Sixteen favorable opinions were published concerning the registration or modification of registration conditions/extension of indications for the medical devices in the List of Reimbursable Products and Services (LPPR). They relate to cardiovascular and peripheral vascular, neurovascular, endocrinology, interventional radiology, nephrology and urology, orthopedic devices, and medical aids.

The French National Authority for Health (HAS) has released new recommendations about add-on reimbursement of medical devices and medical aids from the January 2025 meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Seventeen favorable opinions were published concerning the registration or modification of registration conditions/extension of indications for the medical devices in the List of Reimbursable Products and Services (LPPR). They relate to cardiovascular, endocrine, e-health, interventional radiology, neurology and neurosurgery, orthopedic devices, and medical aids.

On January 28, 2025, the Federal Ministry of Health (BMG) provided updates on implementing the Hospital reform in Germany.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the December 2024 meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Three favorable opinions were published concerning the registration of new medical devices in the List of Reimbursable Products and Services (LPPR). They relate to breast reconstruction and medical aids.

On January 1, 2025, the revised EBM (German Uniform Evaluation Standard) catalog for the first quarter of 2025 came into force. The main changes introduced concern updates of the contents (services legends, preambles of several EBM subchapters), the introduction of new EBM codes related to dialysis services, CT coronary angiography, management of long COVID patients, different types of consultations and visits, and material costs flat rates related to shipping services.

On December 19, 2024, the Dutch Healthcare Institute (ZIN) published the updated list of medical procedures reimbursed under basic health insurance with restrictions or limitations. The procedures have the so-called "claim" codes (aanspraakcodes). The Dutch Healthcare Authority assigns the "claim" codes based on positions published by the ZIN. The changes included the introduction of one new procedure code.