Reimbursement

The “Subsidy for promising care” scheme makes it possible to obtain temporary financing for care that looks promising but is not yet reimbursed from the basic health insurance package. The deadline to apply for funding via this scheme is April 7, 2020.

In late 2019, the Nomenclature was updated. The update brought changes regarding the creation of new codes, deletion of codes, modification of existing codes, and the addition of new reimbursement conditions in the fields of dentistry, ophthalmology (including new codes for optical coherence tomography) and others.

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern repair of femoral hernia requiring removal of previously inserted mesh, transurethral non-ablative radiofrequency of bladder, minimally invasive mitral valve repair, two-stage revision of total hip replacement for infection and others. The codes are introduced with a recommended adoption date being the 1st of May 2020. The document also contains a list of textual changes in codes, unacceptable combinations, and inactivated codes. There were no changes to the CCSD Schedule of Diagnostic Tests.

The French High Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in January 2020 concern various types of devices, mostly for cardiovascular and orthopaedic devices, and medial aids. A total of 29 decisions were made.

New material codes for a set of equipment for the quantification of collateral ventilation in isolated pulmonary compartments and unidirectional endobronchial valve with placement system were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in February 2020.

In January 2020, the Reimbursement Commission made changes to the Healthcare Implementation Communique in Turkey. The main changes relate to the addition of new laboratory test codes, procedure codes, new devices related to the ophthalmology, and price changing of materials related to interventional radiology.

From January 2020, the "Oncotype DX Breast Recurrence Score" test is reimbursed by the health insurance companies at an extra budget of 3,296.50€. This is explicitly the only test that the Federal Joint Committee (G-BA) has included in the contracted medical care.

New material code for a set of nets for the repair of prolapse (for vaginal placement) was added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in January 2020.

The Swiss Services Ordinance (KLV/OPre) is the document that defines the health care services which are covered by the compulsory health insurance in Switzerland. It is updated annually (with more frequent updates possible); thus, the 2020 version is released. Changes concern autologous transplantation of chondrocytes, extracorporeal photopheresis, transcatheter aortic valve implantation, ultrasound therapy focused on the pallidum, thalamus and subthalamus, CAR-T cell therapies, tomography with positron emission (PET/CT), stereotactic radiation therapy (photons) of wet age-related macular degeneration.

The Clinical Coding and Schedule Development (CCSD) group develops and maintains procedural and diagnostics nomenclature for private payers in England. New procedure codes concern removal of pectus bar, open surgical correction of pectus deformity of the chest wall, intradermal injection into the scalp, nerve and neurolytic root block with or without image guidance, facet joint injection with or without image guidance and diagnostic code for gustatory testing. The codes are introduced with a recommended adoption date being the 1st of May 2020. The documents also contain a list of textual changes in codes, unacceptable combinations, and inactivated codes.

The French National Authority for Health (HAS) regularly publishes new decisions about add-on reimbursement for medical devices. The decisions made in December 2019 concern various types of devices, mostly for cardiovascular devices. A total of five decisions were made.

New material codes for implantable non-rechargeable neurostimulator, electrodes, and extensions for stimulation of the dorsal root nodes were added to the List of reimbursable devices of the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) in December 2019.