Reimbursement

The Danish Health Data Authority quarterly updates the Health Care Classification System (SKS). In December 2023, the latest code changes were published to come into force on January 1, 2024. Nine new surgical procedure codes and four new medical (MedTech-related) procedure codes concerning cardiovascular, gastrointestinal, interventional radiology, men’s health, peripheral vascular, radiotherapy, and dermatology were introduced.

In late November – early December 2023, the application period for 2025 ICD-10-GM (German modification of ICD-10 diagnosis codes), OPS (procedure codes), and DRG changes was opened by the Federal Institute for Drugs and Medical Devices (BfArM) and the Institute for Hospital Remuneration Systems (INeK) respectively.

In December 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 with changes to be implemented no later than February 12, 2024. Five new procedure codes (concerning endoscopy, gastrointestinal, and spine) and one new in-vitro diagnostic code were introduced.

On December 21, 2023, the revised EBM (German Uniform Evaluation Standard) catalog for the first quarter of 2024 was published. The most significant changes concern the update of Annex 2 of the catalog, the introduction of the new EBM codes for external electrical cardioversion in adult and pediatric patients, follow-up and evaluation of the health app companion patella, as well as a companion diagnostics test for genotyping to determine CYP2C19 metabolism status.

In November 2023, the Norwegian Directorate of e-Health released an updated version of the Norwegian Laboratory Code (NLK) system and associated tariffs to be implemented no later than January 1, 2024. Eighty-four new codes were added, 77 codes were amended, and 32 codes were terminated.

On December 1, 2023, the Belgian National Institute for Health and Disability Insurance (INAMI/RIZIV) updated several articles of the Nomenclature. New procedure codes with reimbursement fees and associated conditions concerning cardiovascular, neurology, and obstetrics fields were added.

On November 30, 2023, the entity managing the DRG system in Switzerland, SwissDRG, published the final version of the 2024 DRG system. In total, 34 new DRGs were introduced, and they concern cardiovascular, endocrine, gastrointestinal, men’s health, nephrology and urology, neurology and neurosurgery, neuromodulation, obstetrics and gynecology, orthopedics, pulmonary, and some other technology groups. Also, two new add-on reimbursement categories were introduced.

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 November 2023. Seven recommendations were published in relation to the registration of medical devices in the List of reimbursable products and services (LPPR). Opinions concern cardiovascular, nephrology and urology, and orthopedic devices, as well as medical aids.

In the fourth quarter of 2023, two new health technology assessments were initiated by the Agency for Health Technology Assessment and Tariff System (AOTMiT). The assessments belong to the cardiovascular and neurovascular technology groups.

On November 14, 2023, the Institute for the Hospital Remuneration System (InEK) published the DRG catalog (Fallpauschalen-Katalog) with the list of DRGs and additional reimbursement categories (ZEs) for 2024.

On November 16, 2023, the National Association of Statutory Health Insurance Physicians (KBV) informed that Annex 2 of the updated German Uniform Evaluation Standard (EBM) catalog, which is expected to be published on January 1, 2024, will be enriched with an additional 33 interventional procedures.

In November 2023, the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) announced the budget reduction for reimbursement of clinical laboratory services by 15% from January 2024. INAMI-RIZIV considers this reimbursement still sufficient and will reallocate released funds to other projects in health care. The reduction will not impact molecular biological and genetic testing.