Reimbursement for COVID-19 Detection Test in Belgium

23

Mar 2020

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.

Subscribe to our newsletter delivered every second week not to miss important reimbursement information.

The latest related news

22

Jun 2021

In late May 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0177 and 0074 with changes to be implemented not later than August 01, 2021. Five new procedure codes related to diagnostic imaging, ENT, breast reconstruction, and gynecology, and nine new diagnostic codes were introduced.

Read more

16

Jun 2021

The Health Sciences Institute in Aragon (IACS) systematically evaluates healthcare technologies and facilitates the promotion of research, effective innovation, and decision-making in health services through knowledge management. Currently, the IACS is working on assessments of efficacy, effectiveness, and safety of intraoperative radiation therapy in breast cancer, determination of preeclampsia biomarkers SFlt-1 and PlGF, treatment of congenital ventricular septal defect by cardiac catheterization, and others.

Read more

14

Jun 2021

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in May 2021. Recommendations concern orthopedic devices, cardiovascular, peripheral vascular, and neurovascular devices, medical aids, and pulmonary artery pressure sensor.

Read more

07

Jun 2021

In 2013, Norway established a framework, “New Method,” for the introduction of innovations into the health care system through either a national or hospital-based health technology assessment. In this framework, all innovations should undergo HTA before being funded. As of June 7, 2021, five HTAs of in-vitro diagnostics are in progress.

Read more

31

May 2021

The application portal for inclusion in the Health App Directory at the Federal Office for Drugs and Medical Devices (BfArM) in Germany has been online since May 27, 2020. The first reimbursable health apps were introduced on the Directory in early October 2020. As of May 27, 2021, a total of 74 applications were received, 51 of which for provisional listing and 23 for final listing. Fifteen applications (20%) were introduced on the Directory.

Read more