Reimbursement

Between late April and May 2023, three 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, 47 health apps are currently available in the DiGA Directory, and six health apps were delisted from the Directory.

On May 03, 2023, the HAS invited professional organizations and patient associations to submit their applications for inclusion of the topics in the HAS 2024 work program. This is related only to requests to develop new/update existing HAS recommendations and not to the creation of novel procedure codes.

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 April 2023. Twenty-three recommendations were published in relation to the registration, modification of registration conditions, and renewal of registration for devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, orthopedic, nephrology and urology, and surgical devices, as well as medical aids.

On April 20, 2023, the Dutch Healthcare Authority (NZa) published the first release of the DRG package for 2024 (RZ24a). Twenty-three new procedure codes, nine new supplementary payments, and thirteen new DRGs will be implemented across gynecology, pulmonary, extracorporeal treatments, and other technology groups.

On April 14, 2023, a repository of innovative acts outside the nomenclature of biology and anatomopathology (RIHN) and a Supplementary list of IVD tests were published. Minor changes were introduced in the 2023 RIHN list.

On April 19, 2023, the Italian Ministry of Health announced that the State-Regions Conference approved the national tariffs for outpatient specialist care and prosthetic care. These tariffs will be applied to Annexes 4 (outpatient specialist care) and 5 (prosthetic care) of the Essential Levels of Care (LEA) document from 2017. New tariffs for outpatient specialist care will enter into force in January 2024, and the tariffs for prosthetic care will enter into force on April 1, 2024.

In the middle of April 2023, the French National Authority for Health (HAS) published a decision modifying its internal regulations establishing the “Commission for the Evaluation of Diagnostic, Prognostic, and Predictive Technologies (CEDiag)”. This Commission is responsible for preparing the opinions and decisions of the HAS relating to the evaluation of health technologies for diagnostic, prognostic or predictive purposes.

In April 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 189 and 085 with changes to be implemented no later than June 15, 2023. Eighteen new procedure codes (concerning cardiovascular, endocrine, endoscopy, gastrointestinal, interventional radiology, neuromodulation, peripheral vascular, robotic surgery, men's health, and general surgery fields) and eight new diagnostic codes were introduced.

On March 31, 2023, the Agency for Technical Hospital Information published the 2023 DRG tariffs and tariffs for other packages and supplements.

On March 31, 2023, the Ministry of Health and Prevention published the Decree in the Official Journal of the French Republic that defines an application process for the early coverage of digital medical devices for therapeutic purposes and medical telemonitoring by health insurance.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on April 1, 2023. The most significant changes concern introducing the new EBM codes for follow-up and evaluation of the “Invirto” health app, high-frequency endometrium ablation, and reducing the tariff for COVID-19 PCR tests.

On March 16, 2023, the Reimbursement Commission of the Social Security Institution (SSI) released an updated version of the Healthcare Implementation Communique (SUT). The main change relates to the increase in reimbursement fees of services and medical devices. Furthermore, eight new cardiovascular procedure codes were introduced.