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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 October 2020

The revised EBM (German Uniform Evaluation Standard) catalog came into force on October 1, 2020. MTRC has compiled the selection of the most significant changes.

The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalogue (Einheitlicher Bewertungsmaßstab), updated once in a quarter (4 times a year). The adaption time frame of the EBM catalogue for a specific code is around five years but varies depending on the evidence.

The list of the most important changes in EBM for the fourth quarter of 2020 is presented below:

  • In-vitro diagnostics
    • GOP 32779 “SARS-CoV-2” for the antigen testing for the detection of SARS-CoV-2 with a tariff of €10.80 was added
    • GOP 32867 “Genotyping for determination of the dihydropyrimidine dehydrogenase (DPD) metabolism status prior to systemic therapy with 5-fluorouracil or its precursors according to the summary of product characteristics (information for healthcare professionals)” with a tariff of €120 was added
  • Telemedicine
    • GOP 01670 “Surcharge in connection with the insured, basic or consulting flat rate for obtaining a teleconsultation” with a tariff of €12.09 was added
    • GOP 01671 “Assessment of a medical problem via the teleconsultation” with a tariff of €14,06 was added
    • GOP 01672 “Surcharge for the fee order item 01671 for the continuation of the assessment via the teleconsultation” with a tariff of €7.14 per each further five (5) minutes up to three (3) times in case of treatment was added
  • Vacuum wounds therapy
    • GOP 02314 “Additional flat rate for vacuum therapy for the intended secondary wound closure according to No. 33 of Annex I "Recognized examination or treatment methods" of the Guideline Methods for Outpatient Medical Care of the Federal Joint Committee” with a tariff of €14.83
    • GOP 31401 “Surcharge for an intervention under the Section 31.2 for the application of a system for vacuum therapy for the intended primary wound closure in accordance with No. 33 of Annex I "Recognized examination or treatment methods" of the Guideline Methods for Outpatient Medical Care of the Federal Joint Committee” with a tariff of €7.47 was added
    • GOP 36401 “Surcharge for an intervention under the Section 36.2 for the application of a system for vacuum therapy for the intended primary wound closure in accordance with No. 33 of Annex I "Recognized examination or treatment methods" of the Guideline Methods for Outpatient Medical Care of the Federal Joint Committee” with a tariff of €7.03.

The latest version of EBM can be accessed 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). First EU issues of both newsletters are available for download free-of-charge.

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