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The revised EBM catalog came into force in Germany in October 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 adaptation 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, 2023.
The most significant changes concern the introduction of the new EBM codes for several IVD tests, prostate-specific membrane antigen (PSMA) positron emission tomography, as well as for stereotactic radiosurgery (SRS) in vestibular schwannomas.
The examples of newly introduced EBM codes are provided below:
EBM sub-chapter 25.3.2 “High-voltage therapy (at least 1 MeV)”
- 25322 “Single-stage SRS for the first target volume; once in the case of disease” with a tariff of €1,252;
- 25323 “Surcharge for code 25322 for the SRS of more than one target volume; per each additional target volume” with a tariff of €312.91;
- 25348 “Radiation planning for SRS; once in the case of disease” with a tariff of €3,651.
EBM sub-chapter 32.3.7 “Infection immunological examinations”
- 32572 “Qualitative detection and/or quantitative determination of Toxoplasma antibodies of the immunoglobulin class IgM and/or IgG, also for monitoring purposes” with a tariff of €11.75;
- 32573 “Surcharge for code 32572 for determining the avidity of Toxoplasma IgG antibodies as a clarification test after positive IgM antibody determination, in several batches, in total” with a tariff of €25.90.
EBM sub-chapter 34.7 “Diagnostic positron emission tomography (PET), diagnostic positron emission tomography with computed tomography (PET/CT)”
- 34720 “Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) of the trunk with technical image fusion of a diagnostic computed tomography (CT) for the indication of therapy with (177Lu) lutetium vipivotide tetraxetan, if diagnostic CT examinations are available” with a tariff of €512.06;
- 34721 “PSMA positron emission tomography (PET) of the trunk with technical image fusion of a diagnostic computed tomography (CT) for the indication of therapy with (177Lu) lutetium vipivotide tetraxetan, with diagnostic CT” with a tariff of €649.61.
In connection with the procedures under the EBM codes 34720 and 34721, the code 40585 “Flat rate for material costs in connection with the performance of the services under the codes 34720 and 34721 when using a Ga-68-PSMA ligand” under the EBM sub-chapter 40.10 “Performance-related flat rates for radionuclides” with a tariff €1,100 was introduced.
The full details in German can be found here.
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