Proton Therapy

Number of report

Ask the expert

(we accept only company emails)

The report presents a summary of reimbursement situation for proton therapy in European countries.      

The analysis covers the application of proton therapy in ocular tumors in adults and pediatric medulloblastoma.

The analysis is provided for the session and out-patient treatment,  including both preparation and delivery of proton therapy. The only reimbursement within public / statutory health insurance systems is considered.

The report includes essential information about reimbursement, including:

  • Brief country-specific overview of reimbursement system
  • Procedure coding for technology
  • Diagnosis coding
  • Payment mechanism for technology
  • Reimbursement tariffs for technology
  • Restrictions on indications or scenarios for the use of technology
  • Policy considerations by payers and policy-makers about technology

Reimbursement information is provided for the following geographies:

  • Austria
  • Belgium
  • Denmark
  • England (UK)
  • Finland
  • France
  • Germany
  • Italy
  • The Netherlands
  • Norway
  • Sweden
  • Switzerland

Manufacturers of equipment for proton therapy include:

  1. Hitachi Medical Systems (PROBEAT-RT)
  2. IBA (Proteus ONE, Proteus Plus)
  3. Mevion (MEVION S250)
  4. Sumitomo Heavy Industries (HM series)
  5. Varian Medical Systems (ProBeam, ProBeam Compact, ProBeam Multi-Room)

Table of content 

1.    Introduction and summary
2.    Executive summary table
3.    Contents
4.    Abbreviations
5.    What’s new
6.    Methodology
7.    Reimbursement analysis in Austria

7.1.    Overview of the reimbursement system
7.2.    Reimbursement for proton therapy
7.2.1.    Policy considerations    Health technology assessments by LBI-HTA
8.    Reimbursement analysis in Belgium
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for proton therapy
8.2.1.    Procedure coding
8.2.2.    Policy considerations by the INAMI/RIZIV    Health technology assessments by KCE
9.    Reimbursement analysis in Denmark
9.1.    Overview of the proton therapy
9.2.    Reimbursement for intensity modulated radiotherapy
10.    Reimbursement analysis in England
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for proton therapy
10.2.1.    Commissioning of proton therapy 
10.2.2.    Health technology assessments by NICE
11.    Reimbursement analysis in Finland
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for proton therapy
12.    Reimbursement analysis in France
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for proton therapy
12.2.1.    Procedure coding 
12.2.2.    Diagnosis coding
12.2.3.    Payment mechanism and reimbursement tariffs
12.2.4.    Policy considerations by HAS
13.    Reimbursement analysis in Germany
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for proton therapy
13.2.1.    Procedure coding 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs
13.2.4.    Policy considerations by G-BA
14.    Reimbursement analysis in Italy
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for proton therapy
14.2.1.    Procedure coding
14.2.2.    Payment mechanism and reimbursement tariffs 
14.2.3.    Policy considerations
15.    Reimbursement analysis in the Netherlands
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for proton therapy
15.2.1.    Procedure coding 
15.2.2.    Payment mechanism and reimbursement tariffs
15.2.3.    Policy considerations by Dutch Healthcare Institute (ZIN)
16.    Reimbursement analysis in Norway
16.1.    Overview of the reimbursement system
16.2.    Reimbursement for proton therapy
16.2.1.    Procedure coding 
16.2.2.    Diagnosis coding
16.2.3.    Payment mechanism and reimbursement tariffs
16.2.4.    Policy considerations 
17.    Reimbursement analysis in Sweden
17.1.    Overview of the reimbursement system
17.2.    Reimbursement for proton therapy
17.2.1.    Procedure coding 
17.2.2.    Diagnosis coding
17.2.3.    Payment mechanism and reimbursement tariffs
17.2.4.    Policy considerations 
18.    Reimbursement analysis in Switzerland
18.1.    Overview of the reimbursement system
18.2.    Reimbursement for proton therapy
18.2.1.    Procedure coding 
18.2.2.    Diagnosis coding
18.2.3.    Payment mechanism and reimbursement tariffs
18.2.4.    Policy considerations
19.    Summary of procedure codes
20.    Summary of reimbursement codes and tariffs
21.    Disclaimer


Apr 2018

Eight reimbursement reports with the total size of 882 pages cover the most common radiotherapy modalities including brachytherapy, 3D conformal radiation therapy, stereotactic radiosurgery, stereotactic body radiation therapy, intensity-modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), image-guided radiotherapy, proton therapy. The analysis covers procedure coding, payment mechanism, reimbursement tariffs and policy restrictions in 12 EU countries including Austria, Belgium, Denmark, England, Finland, France, Germany, Italy, the Netherlands, Norway, Sweden and Switzerland.

Read more


Apr 2018

In April 2018, Danish Health Authority published 163 new codes for the Health Care Classification System, including five diagnosis codes, 34 surgical and 29 medical procedure codes. These codes are used to classify procedures in Danish DRG system.

Read more


Mar 2018

The background for updating the National Clinical Guideline for Treatment of Brain Metastases is that local treatment (stereotactic radiation therapy) has gained more space in the treatment of brain metastases.

Read more


Mar 2018

The Clinical Coding and Schedule Development Group develops and maintains procedural and diagnostics nomenclature for private payers in England. In February new codes for preparation and delivery of radiotherapy, knee resurfacing arthroplasty, balloon dilatation of the Eustachian tube and MRI-guided focused ultrasound (MRgFUS) thalamotomy for essential tremor were added to the CCSD Schedule.

Read more


Mar 2018

Interstitial low-dose rate brachytherapy was commissioned to the Institute for Quality and Efficiency in Health Care (IQWiG) by the Federal Joint Committee (G-BA) in order to analyze the current knowledge on procedure.

Read more


Feb 2018

The background for updating the National Clinical Guideline for Treatment of Brain Metastases is that local treatment (stereotactic radiation therapy) has gained more space in the treatment of brain metastases.

Read more


Jan 2018

The Department of Home Affairs (EDI) in Switzerland decided upon the coverage with evidence development (CED) of two types of positron emission tomography as well as stereotactic radiotherapy (photons) of exudative age-related macular degeneration. The status is given to contested medical services for a specific period which is extended until evidence is complete.

Read more
(we accept only company emails)