Reimbursable outpatient and in-hospital services provided by physicians are listed in the Common Classification of Physician Services (CCAM). The French National Authority for Health (HAS) evaluates evidence in the process of creating new CCAM codes. For non-interventional procedures, the creation of a specific CCAM code procedure and introduction into DRG with the appropriate tariff is required.
The process of creating new CCAM codes consists of several phases at the HAS and French National Union of Health Insurance Funds (UNCAM). The process to introduce a new CCAM procedure code typically takes 3 to 5 years. The ultimate coverage decision was made by the UNCAM.
In this White Paper, MTRC identified evidence requirements for the creation of CCAM codes for diagnostic (non-IVD) procedures performed by physicians based on an analysis of four recent HAS reports with positive and negative recommendations. The analysis was performed in February 2024.
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