Reimbursement

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.

On December 17, 2022, the Ministry of Health and Prevention published an Order in the Official Journal of the French Republic on the transitional coverage for the renal denervation catheter SYMPLICITY SPYRAL.

In December 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletin 187 with changes to be implemented in procedural classification no later than February 8, 2023. Five new procedure codes were introduced concerning orthopedic, surgical procedures, and men’s health. No changes were made to the diagnostic schedule.

On December 19, 2022, NHS Digital released HRG4+ Consultation Grouper for 2023/24 to support NHS England’s consultation process for the 2023/25 NHS Payment Scheme. There are no new HRGs or other significant changes in the 2023/24 Consultation Grouper. Local Payment Grouper will supersede Consultation Grouper in March 2023 for use from April 1, 2023.

On December 19, 2022, the Dutch Healthcare Institute (ZIN) published the updated list of medical procedures reimbursed under basic health insurance with restrictions or limitations. The procedures that were newly introduced to the list concern gynecological and surgical procedures, as well as interventional radiology.

In late December 2022, the National Association of Statutory Health Insurance Physicians (KBV) published a detailed overview of the changes in the reimbursement of outpatient surgeries to be introduced in Germany in 2023, which are aimed at expanding the utilization of these procedures by physicians.

In December 2022, the Norwegian Directorate of Health published the final version of the DRG system (Innsatsstyrt finansiering, ISF) for 2023. Eight new DRGs concerning endocrinology, surgical procedures, infection diseases, genetics, and the general area will be added in 2023.