Reimbursement

In January 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 0174 and 0071 with changes to be implemented not later than May 01, 2021. Five new procedure codes related to the areas of men's health, robotic surgery, endoscopy, and orthopedics, as well as three new diagnostic codes, were introduced.

On January 25, 2021, the Norwegian Directorate of e-Health released a regular update of the Norwegian Laboratory code (NLK) system (version 7280.54) and associated tariffs for state and private laboratories to be implemented not later than March 01, 2021. In this update, 63 new codes were introduced. On February 02, 2021, an extra update was issued (version 7280.55) to be implemented not later than April 01, 2021. Five new codes for the analyses of mutated SARS-CoV-2 were introduced in this update.

On January 19, 2021, the 2021 tariffs for APR-DRG groups, as well as the distribution of total amount within DRG among all specialists and services which are provided by them, were published. Except for the update of the tariffs, no other changes were introduced within the Belgian DRG system.

On January 11, 2021, a new version of the Nomenclature of Medical Biology Acts (NABM068) was released. One new code for detecting the genome of the influenza A and B viruses by RT-PCR was introduced.

On January 18, 2021, a new version of the List of Reimbursable Products and Services (LPPR) was published. It contains new devices included in the LPPR list in November-December 2020, as well as other modifications made during this period. Newly-introduced devices belong to the cardiovascular (coronary stents), orthopedic, neuromodulation (deep brain stimulation), peripheral vascular (stent-grafts to treat aortic abdominal aneurysm), and other areas of care.

On January 20, 2021, the National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the reimbursement pathway for health apps. Health apps can now reach level M3 of the validation pyramid.

On December 28, 2020, the Government of the Russian Federation released a Decree which approved the program of State Guarantees in Health Care for 2021. The program determines the average level of financing of health care services, but most importantly, the list of procedures covered as part of the High-End Medical Care. The newly introduced High-End Medical Care lists changes concern the cardiovascular, neurological, ENT, surgical procedures, endocrine, orthopedics, dermatology, and other technology groups.

In early January 2021, the new reimbursable health app was introduced on the Directory of digital health applications (DiGAs) at the Federal Office for Drugs and Medical Devices (BfArM). These applications can be prescribed by physicians and psychotherapists and will be reimbursed by health insurers.

On January 1, 2021, the DRG package for 2021 (RZ21) came into force to implement measures for remote provision of specialist medical care introduced during the COVID-19 crisis in 2020, including four new codes for reimbursement of remote consultations.

The revised EBM (German Uniform Evaluation Standard) catalog came into force on January 1, 2021. The most significant changes include the increase of the reimbursement base rate and the introduction of many new surcharge fees in the area of radiotherapy services.

On December 23, 2020, NHS England and NHS Improvement published the final document for updating the National Genomic Test Directory (Test Directory), as well as other documents supporting the application process for amendments. The deadline for applications submission for 2021/22 Test Directory is January 31, 2021.

On December 16, 2020, the Ministry of Solidarity and Health issued a few Orders on the registration of certain endoprostheses by Cook Medical in the List of Reimbursable Products and Services (LPPR) for add-on reimbursement. Conditions of reimbursement for vascular endoprostheses were specified.