Reimbursement

In mid-November 2024, a new version of the classification of procedure codes (CCAM v.77), effective from January 1, 2025, was published. No new codes were introduced. The main changes concerned the tariff rules for procedures and their applications for doctors, as well as the modification of tariffs for 31 dental procedures.

On November 17, 2024, the French Ministry of Health and Access to Care published an Order in the Official Journal of the French Republic on the support and reimbursement of reinforced care pathways – a direct outcome of the experimental projects under Article 51 of the Social Security Financing Act of 2018, which aimed to innovate healthcare delivery and financing models. The new framework aims to enhance the coordination and quality of care for patients with complex health needs and provides financing for coordinated care projects.

On November 14, 2024, the State-Regions Conference approved the Decree with the new national LEA tariffs for outpatient specialist care and prosthetic care presented by the Italian Ministry of Health. The effective date of new tariffs is December 30, 2024.

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 October 2024. Ten recommendations were published concerning the registration or modification of registration conditions/extension of indications for the medical devices in the List of Reimbursable Products and Services (LPPR). Opinions concern cardiovascular, peripheral vascular, neurovascular, and interventional radiology devices, as well as medical aids.

In October 2024, the Norwegian Directorate of Health published a preliminary version of the DRG system (Innsatsstyrt finansiering, ISF) for 2025. Two new DRGs concerning men’s health and dental areas will be introduced.

On October 01, 2024, the Dutch Healthcare Authority (NZa) published the second release of the 2025 DRG package (RZ25b), which implemented a new procedure code for supporting joint decision-making in outpatient specialist care and supplementary payment proactive planning of palliative care.

On October 01, 2024, the Dutch Healthcare Authority (NZa) published the second release of the 2025 DRG package (RZ25b). Three new procedure codes, four new supplementary payments (OZPs), 18 new diagnosis codes, and two new DRGs will be implemented across gastroenterology, surgery, diagnostic imaging, molecular diagnostics, and other areas.

On October 9, 2024, the new version of the Nomenclature of Medical Biology Procedures (NABM 93) was released in France. Changes included the introduction of five new codes and wording modifications for several codes.

In October 2024, the updated version of the intra-DRG list was published in France. Three new devices were registered in the cardiovascular and neurovascular fields. Furthermore, one device was removed from the list, and the registration conditions for several devices were changed.

On September 16, 2024, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) announced that they had reached an agreement in financing negotiations concerning outpatient care.

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 September 2024. Five recommendations were published concerning the registration or modification of registration conditions/extension of indications for the medical devices in the List of Reimbursable Products and Services (LPPR). Opinions concern endocrine and spine devices, as well as medical aids.

On September 18, 2024, the Organization for Outpatient Physician Tariffs (OAAT) AG announced that the comprehensive tariff system, including the TARDOC catalog of individual service tariffs and outpatient flat rates, is now available for review by interested parties. As emphasized by the OAAT AG, the new system has not been approved yet. After the partial approval by the Swiss Federal Council in June 2024, the implementation of the new system was postponed until January 2026.