Reimbursement

On January 3, 2024, the entity managing the DRG system in Switzerland, SwissDRG, announced that they will be accepting applications for changes in the DRG system from June 3, 2024, until July 15, 2024. The results of the DRG applications made in 2024 will be reflected in the 2026 version of SwissDRG.

NHS England defined a deadline for applications to the High Cost Device List (HCDL) changes to be implemented in the 2025/26 NHS Payment Scheme. The completed application form should be submitted via email by May 31, 2024.

On January 01, 2024, the Dutch Healthcare Institute (ZIN) published the updated list of medical procedures reimbursed under basic health insurance with restrictions or limitations. The procedures that were newly introduced to the list concern pulmonary, gynecology and ENT procedures, as well as genetic testing.

In December 2023, NHS England launched a consultation regarding proposed changes in the 2023/25 NHS Payment Scheme for the 2024/25 financial year. The key changes concerned the High Cost Device List, top-up payments for specialized services, and payment for radiotherapy. The deadline for submitting comments is January 26, 2024.

In December 2023, the Norwegian Directorate of Health published a final version of the DRG system (Innsatsstyrt finansiering, ISF) for 2024. In general, no significant changes were introduced. No new DRGs will be added. One new Special Service Group (STG) for light treatment and five new Service Progress Groups (TFGs) concerning maternity care pathways and rehabilitation will be introduced.

On December 20, 2023, the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) announced that from January 1, 2024, the catalog for ambulatory operations in hospitals (AOP catalog) will be significantly expanded – 171 interventional procedures will be included in the catalog.

In December 2023, the Dutch Healthcare Institute (ZIN) published two coverage positions on high-intensity focused ultrasound (HIFU) in patients with essential tremor with positive recommendation for coverage under basic insurance package, and on radiotherapy with magnetic resonance linear accelerator, which was not recommended for coverage under the basic insurance package.

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.