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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 2022

The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalog (Einheitlicher Bewertungsmaßstab), updated once a quarter (4 times a year). The adaption timeframe of the EBM catalog for a specific code is around five years but varies depending on the evidence. The latest EBM (German Uniform Evaluation Standard) catalog came into force on October 1, 2022.

The most significant changes concern introducing the EBM codes for several IVD tests and a new service in artificial insemination.

The new codes in the IVD field introduced in the EBM catalog:

  • 19465 “Detection or exclusion of all known MET exon 14 skipping mutations using circulating tumor DNA to indicate targeted treatment of adult patients with advanced non-small cell lung cancer when mandatory according to the prescribing information” with a tariff of €443.21;
  • 32868 “Genotyping to determine UDP-glucuronosyltransferase 1A1 (UGT1A1) metabolization status prior to systemic therapy with an irinotecan-containing medicinal product” with a tariff of €50.

Also, the following new code for hormonal preparation of the endometrium for artificial insemination after cryopreservation of unfertilized egg cells was included in the EBM catalog:

  • 08536 “Hormonal preparation of the endometrium in line with number 12.3 letter b in the case of medical indication according to the number 11.5 letter b of the Directive on artificial insemination for carrying out extracorporeal insemination using intracytoplasmic sperm injection (ICSI), once in the cycle” with a tariff of €37.74.

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).

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