Reimbursement

On January 3, 2023, the Federal Joint Committee (G-BA) initiated the evaluation procedure concerning the method of renal denervation using ultrasound ablation in treatment-resistant hypertension (Paradise-System™ by ReCor Medical) within the framework of the early benefit assessment (in line with § 137h SGB V).

On January 09, 2023, the National Institute for Health and Disability Insurance (INAMI-RIZIV) published 2023 tariffs for the “low variability care” (APR-DRG) system. APR-DRG logic for 2023 is not published as of January 27, so no information about its changes or new DRGs is available.

The updated German Uniform Evaluation Standard (EBM) catalog came into force on January 1, 2023. The EBM catalog (Einheitlicher Bewertungsmaßstab) regulates the reimbursement of services in the public outpatient sector in Germany and is updated once a quarter (four times a year). Among other changes, a new code for "zanadio" health app for follow-up and evaluation was introduced in the catalog.

On December 31, 2022, the Decree defining the reimbursement of medical telemonitoring activities via the new framework was published in the Official Journal of the French Republic. The Decree determines the methods of evaluation of digital solutions, registration for reimbursement, modification of the registration conditions, removal and invoicing of medical telemonitoring activities, as well as the conditions for setting the reimbursement packages.

In December 2022, NHS England launched a consultation on the preliminary 2023/25 NHS Payment Scheme, which is set for two years and will replace the National Tariff Payment System from April 2023. Two new cardiovascular categories (antibacterial envelope, mitral valve repair and replacement devices) are proposed for inclusion in the 2023/24 High Cost Device List (will be updated and reissued for 2024/25). The deadline for comments submission is January 27, 2023.

On December 26, 2022, 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 sickness funds.

On January 1, 2023, the annual update of the Finnish NordDRG system came into force. There are 947 DRGs in the 2023 DRG system, compared to 930 DRGs in 2022. Among other changes, 34 new DRGs were introduced, including the DRGs in the cardiovascular, endocrine, endoscopy, gastrointestinal, obstetrics and gynecology, orthopedics, peripheral vascular, surgical procedures, and some other fields.

In January 2023, the updated Pathology Activity Codes (APAT) of the Norwegian Pathology Code system (NORPAT) came into force. Since 2022, APAT codes have been included in the new reimbursement scheme by Helfo (the Norwegian Health Economics Administration) for outpatient pathology services. Five new classified sample materials for cytology and 22 new additional codes for the method of testing were added to the scheme in 2023.

On December 23, 2022, NHS England published a preliminary 2023/25 NHS Payment Scheme and launched a consultation. NHS Payment Scheme will replace the National Tariff Payment System from April 1, 2023. The deadline for comments submission is January 27, 2023.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on January 1, 2023. The most significant changes concern introducing the EBM codes for several IVD tests and further promoting outpatient (day case) surgical services.

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 December 2022. Nine 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 the device used for neuromodulation, the device for the treatment of benign prostatic hyperplasia, orthopedic devices, as well as medical aids.

On December 19, 2022, the Dutch Healthcare Authority (NZa) issued a draft release of the DRG package for 2024, including new procedure codes, new diagnosis codes, and several new DRGs. These changes concern pulmonary, gynecology, ENT, orthopedics, and other technology groups.