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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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Reimbursement for COVID-19 Detection Test in Belgium

Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) has issued an agreement document on March 17, 2020, providing principles for billing and funding the Coronavirus (COVID-19) Detection Tests. Previously in Protocol for Hospitals on March 10, 2020, it was outlined that COVID-19 tests performed outside the National Reference Center for Respiratory Pathogens at UZ Leuven have no specific nomenclature codes, and no reimbursement was provided, therefore, was paid by patients. The new agreement clarifies principles for reimbursement, but the invoicing for the tests still on hold.

Tests to detect the COVID-19 coronavirus are centralized at the National Reference Center for Respiratory Pathogens at UZ Leuven (CNR). For a screening test that is carried out in the CNR, the costs are fully reimbursed by the public authorities, and the patient does not pay anything. INAMI has noted that tests are carried out in different hospitals and laboratories outside of CNR procedures, which can be found on the Sciensano website. As there are no specific nomenclature codes for these tests, it was sometimes charged to patients.

INAMI brought together all the parties concerned - clinical biology laboratories (ambulatory, hospitals, Reference centers), mutual societies, and Sciensano, and issued the agreement document on March 17, providing principles on which further reimbursement for the COVID-19 tests will be based. The most important are:

  • The invoicing for the COVID-19 tests remains on hold
  • Health care insurance will provide full reimbursement, with no possibility of extra charge The funding of the reference center will be adjusted according to the activity carried out
  • Reimbursement will be provided for tests that meet the Sciensano case definition or performed due to a clinical need. Patients do not pay user fees for these tests. For the tests that do not meet these conditions, a maximum amount will be fixed. Specific conditions for repeated tests will be established
  • Laboratory (ambulatory, hospitals, referral centers) collect all the necessary information (number of tests, personnel cost, infrastructure) to determine the reimbursement. They are examining whether the available capacity can be optimized
  • Reimbursement will be provided from a date to be determined (start of the corona crisis)

However, no codes and tariffs are available for now. INAMI will keep the public updated

See the full details in French here.

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