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Reimbursement

05
May 2023

National tariffs for outpatient specialist care and prosthetic care approved in Italy

On April 19, 2023, the Italian Ministry of Health announced that the State-Regions Conference approved the national tariffs for outpatient specialist care and prosthetic care. These tariffs will be applied to Annexes 4 (outpatient specialist care) and 5 (prosthetic care) of the Essential Levels of Care (LEA) document from 2017. New tariffs for outpatient specialist care will enter into force in January 2024, and the tariffs for prosthetic care will enter into force on April 1, 2024.
02
May 2023

Commission for the Evaluation of Diagnostic, Prognostic, and Predictive Technologies established at the HAS in France

In the middle of April 2023, the French National Authority for Health (HAS) published a decision modifying its internal regulations establishing the “Commission for the Evaluation of Diagnostic, Prognostic, and Predictive Technologies (CEDiag)”. This Commission is responsible for preparing the opinions and decisions of the HAS relating to the evaluation of health technologies for diagnostic, prognostic or predictive purposes.
01
May 2023

New procedure and diagnostic codes added to the private reimbursement schedule in England

In April 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 189 and 085 with changes to be implemented no later than June 15, 2023. Eighteen new procedure codes (concerning cardiovascular, endocrine, endoscopy, gastrointestinal, interventional radiology, neuromodulation, peripheral vascular, robotic surgery, men's health, and general surgery fields) and eight new diagnostic codes were introduced.
21
Apr 2023

The revised EBM catalog came into force in Germany in April 2023

The revised EBM (German Uniform Evaluation Standard) catalog came into force on April 1, 2023. The most significant changes concern introducing the new EBM codes for follow-up and evaluation of the “Invirto” health app, high-frequency endometrium ablation, and reducing the tariff for COVID-19 PCR tests.
20
Apr 2023

New procedure codes introduced in Turkey

On March 16, 2023, the Reimbursement Commission of the Social Security Institution (SSI) released an updated version of the Healthcare Implementation Communique (SUT). The main change relates to the increase in reimbursement fees of services and medical devices. Furthermore, eight new cardiovascular procedure codes were introduced.
19
Apr 2023

Experiment to measure the budget impact of digital medical devices launched in France

On March 24, 2023, the French National Authority for Health (HAS) announced a three-year experiment on the health economic evaluation of digital medical devices (DMD). This will allow manufacturers to voluntarily provide a budget impact analysis (indicating a cost-saving effect on the healthcare system) that can support the registration of their DMDs in the LPPR List and a pricing decision.
13
Apr 2023

Recommendations about add-on reimbursement for medical devices in France in March 2023

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 March 2023. Fifteen 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 cardiovascular and peripheral vascular, endocrine, endoscopy, gastrointestinal, surgical, and diagnostic imaging devices, as well as medical aids.
12
Apr 2023

OPCS-4.10 procedural classification came into force in England

OPCS-4 is the clinical coding classification of interventions and procedures undertaken within the NHS in England. It is updated every three years, reflecting current clinical practice to be used for statistical purposes and reimbursement. On April 1, 2023, a new version (OPCS-4.10) came into force. A total of 236 new four-character codes were introduced in multiple areas, including cardiovascular, endoscopy, ENT, gastrointestinal, urology, neurology, gynecology, breast reconstruction, and others.
11
Apr 2023

Danish Health Care Classification System updated in April 2023

On April 1, 2023, an updated version of the Health Care Classification System (SKS) came into force. The Danish Health Data Authority quarterly updates the SKS system, which includes coding for procedures, diagnoses, and other coding (e.g., administrative, pharmaceuticals). In the current version, eight new surgical procedure codes, one medical procedure code, multiple codes for regional anesthesia, one code for diagnostic imaging, one for nuclear medicine, and several additional codes were implemented.