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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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The revised EBM catalog came into force in Germany in April 2023

The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalog (Einheitlicher Bewertungsmaßstab), updated once a quarter (four times a year). The adaption timeframe of the EBM catalog for a specific code is around five years, but it varies depending on the evidence. The latest 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.

The examples of newly introduced EBM codes are provided below:

  • 01474 “Additional flat rate for the follow-up and the evaluation of the digital health application (DiGA) Invirto according to the Directory for digital health applications in line with § 139e SGB V for the following indications: agoraphobia with and without the panic disorder (module “Agora”) or panic disorder (module “Panic”) or social phobias (module “Social”)” with a tariff of €7.35;
  • 40685 “Flat rate for material costs in connection with performing high-frequency ablation of the endometrium using a mesh electrode in line with code 31319” with a tariff of €1,020.

Also, the tariff for the EBM code 32816 “Nucleic acid detection of the beta coronavirus SARS-CoV-2” now amounts €19.90 (previously - €27.30).

The full details in German can be found here.

This news is just one of about 300 market access news collected by our team in the subscription services "HTA Alerts" and "Reimbursement Alerts" every two weeks from more than 80 organizations. Access our paid subscription services to stay on top of all developments specifically for your products in Europe (reimbursement news) and globally (HTA news). Contact us to get a free, three-month, no-obligation trial.