Remote monitoring coding and reimbursement for implantable devices

Series
Telemedicine and digital health
Status
Published
Date
Number of report
031

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The report presents a summary of a current reimbursement situation remote monitoring procedures out-patient specialist settings for implantable devices.

Report includes:

  • Specific procedure coding for remote monitoring of implantable devices
  • Reimbursement model for remote monitoring services
  • Approved frequency of remote monitoring and other conditions

The only reimbursement within public / statutory health insurance systems is considered.

Reimbursement information is provided for the following geographies:

  • Belgium
  • England (UK)
  • France
  • Germany
  • Italy
  • Netherlands
  • Norway
  • Sweden
  • Switzerland

Table of content is not available at the moment.

22

Oct 2020

The revised EBM (German Uniform Evaluation Standard) catalog for ambulatory reimbursement in Germany came into force on October 1, 2020. MTRC has compiled the selection of the most significant changes, concerning In-vitro diagnostics, telemedicine and vacuum wounds therapy.

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27

Aug 2020

In August 2020, mHealthBelgium announced two more health application accomplished M2 validation - Well@Home and AirView. After achieving M2 level, developers will get access to more options, like risk assessment framework, test centers, a lot of useful information.

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17

Aug 2020

The temporary reimbursement for telemedicine and digital care in all healthcare sectors has been extended by the Dutch Healthcare Authority (NZa) until December 31, 2020. In some sectors, the temporary extension will be converted into a structural extension by 2021.

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11

Aug 2020

In July 2020, the Austrian Institute for Health Technology Assessment (AIHTA) published five decision support documents. The assessed technologies included implantation of a wireless pulmonary artery pressure sensor in patients with advanced heart failure, intrauterine ultrasound-guided transcervical radiofrequency ablation, percutaneous transvascular implantation of a coronary sinus reducing stent, radiofrequency-induced intravesical chemohyperthermia for non-muscle invasive bladder cancer, and Vascular photodynamic therapy with Padeliporfin (Tookad® solution).

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01

Jun 2020

In spring 2020, the French High Authority for Health, HAS, has announced the call for public consultation with the purpose of developing a draft functional classification of the digital solutions (for example, health apps, web platforms). The call ends on June 30, 2020.

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01

Apr 2020

Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) has introduced two new service codes for physicians’ teleconsultation regarding COVID-19. INAMI Insurance Committee established a reimbursement fee of €20.

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20

Feb 2020

In late January 2020, the Charité - Universitätsmedizin Berlin and health insurance provider Barmer have signed an integrated care contract for the telemedical management of patients with chronic heart failure. Also, the benefit assessment process at the Federal Joint Committee (G-BA) has already started, and a result is expected in spring 2021.

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12

Dec 2019

With the support of Aaron.ai, the first health application from the project “KBV Future Practice” ("KBV-Zukunftspraxis") was launched in Germany. About 50 medical practices are now testing the smart telephone assistant in their daily work. The evaluation of the practical tests is carried out by the Charité.

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21

Nov 2019

In order to promote the video consultations, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) have agreed on several new regulations. Thus, a video consultation will also be possible if the patient has not been previously treated by the doctor. For psychotherapies, the video consultations were reopened.

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30

Sep 2019

At the beginning of August 2019, North Rhine-Westphalia presented the plans for “Virtual Hospital,” a digital platform that will bundle specialist expertise nationwide and make it more accessible.

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26

Sep 2019

A positive conclusion regarding the model project “Rhineland-Palatinate breathes through - telemedicine for healthy lungs” (“Rheinland-Pfalz atmet durch – Telemedizin für eine gesunde Lunge”) was drawn by the Mainz Ministry of Health.

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16

Sep 2019

National Institute for Health and Disability Insurance (INAMI) is currently developing a framework for the reimbursement of telemedicine and health apps (mHealth).

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29

Aug 2019

The draft for a “Digital Supply Law,” approved by the Cabinet on July 10, 2019, promotes digitization in the health sector. Among other things, the law should help to accelerate the integration of digital applications into the standard care, to further develop and promote the use of the electronic patient record (ePA), to strengthen telemedicine and to connect more actors to the telematics infrastructure.

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21

Aug 2019

Zorg van Nu information team published a brochure with regulations for stimulating digital care in the Netherlands. The brochure with the description of 16 schemes clearly explains which regulations are applicable for which e-health innovations.

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23

Jul 2019

The French High Authority for Health (HAS) develops clinical guidelines and recommendations whose objective is to guarantee the quality and safety of care delivery within the French setting. In the second quarter of 2019, clinical guidelines/recommendations have been developed for 16 topics.

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10

Jul 2019

After having identified the eligibility conditions for teleconsultation and teleexpertise in 2018, the French High Authority for Health (HAS) published a series of documents in late June 2019, for the operational deployment of eHealth services. Each of the new modalities of practice is discussed: teleconsultation, teleexpertise, and teleimaging. Also, the HAS proposed an information document to be given to patients before a teleconsultation.

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30

May 2019

The Federal Joint Committee (G-BA) has signed a further contract for scientific monitoring and implementation of a trial study for NYHA III heart failure therapy optimization by means of continuous blood pressure measurement and monitoring using an implanted sensor in the pulmonary artery.

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27

Mar 2019

On the Interterritorial Council that took place March 4th, 2019, the Working Plan for the Spanish Network for Health Technology Assessment was agreed and published. The working plan includes 22 health technology assessment reports, 7 monitoring studies, 9 clinical practice guidelines, and 1 evidence-based product.

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15

Feb 2019

In January 2019, the German Institute for Quality and Efficiency in Health Care (IQWiG) has selected four medical topics from citizens' suggestions for scientific assessment in the form of HTA reports (depression in children, mHealth solutions for multiple sclerosis, elephantiasis, and pain in endometriosis).

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30

Jan 2019

In late 2018, the French Ministry of Health announced that the telemedicine pilot project “ETAPES” will be maintained for four more years.

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26

Sep 2018

In the second half of July, the National Institute for Health and Care Excellence (NICE) published five new Interventional Procedure Guidance for low-intensity pulsed ultrasound to promote healing of fresh fractures at low risk of non-healing, fresh fractures at high risk of non-healing, superior capsular augmentation for massive rotator cuff tears, transaxial interbody lumbosacral fusion for severe chronic low back pain and two new Medtech Innovation Briefings for remote ECG interpretation consultancy services for cardiovascular disease and mechanical thrombectomy devices for acute ischaemic stroke.

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27

Jun 2018

Remote follow-up for chronically ill patients is included in a new trial that will start in Norway in autumn 2018. Six municipal cooperation projects received grants to participate in this trial in collaboration with the National Welfare Technology Program (Nasjonalt velferdsteknologiprogram).

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14

May 2018

Dutch Healthcare Authority (NZa) has published the DBC product structure and maximum tariffs for specialist medical care for 2019. Healthcare providers and health insurers can start using it for the contract negotiations for 2019. The most important changes include reimbursement for telemonitoring consultation and reimbursement tariffs

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28

Mar 2018

The Dutch Healthcare Authority (Nederlandse Zorgautoriteit) has published a draft version of the DBC package for specialist medical care for 2019 (RZ19a).

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21

Mar 2018

The Institute for Quality and Efficiency in Health Care (IQWiG) released the final report on the assessment of benefit for telemonitoring of cardiac implantable electronic devices compared to a standard treatment without telemonitoring in patients with ventricular tachyarrhythmias and / or heart failure. It was concluded that the benefits of the telemonitoring for patients with cardiac failure or heart rhythm disorders with a fast heart rate remain unclear.

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14

Feb 2018

The Dutch Healthcare Authority (Nederlandse Zorgautoriteit) has published a draft version of the DBC package for specialist medical care for 2019 (RZ19a).

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29

Jan 2018

The rules describe types of telemedicine systems used, type of care to be eligible for telemedicine services, interaction of medical personnel using telemedicine systems, approach for remote monitoring of condition of patient, and approach for documenting and storing information obtained using telemedicine technologies.

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29

Dec 2017

The Basque Office for Health Technology Assessment (OSTEBA) published results of assessments of home telemonitoring on patients with heart failure. This intervention was considered as effective and cost-effectiveness technology. However, further research is needed to specify criteria for better application.

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18

Dec 2017

The meeting Improvement of Patient Quality of Life and Access to Innovation: Two Priorities in Medical Device Evaluations was organized by HAS on 24th of November to discuss evaluation principles of medical devices in France with manufacturers. In connection to the meeting new and updated policy documents were released.

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13

Dec 2017

The changes of the DBC package for specialist medical care in 2019 (RZ19a) will include pediatric oncology, proton therapy, and telemedicine.

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10

Oct 2017

At the beginning of August 2017, the French National Authority for Health (HAS) published a health technology assessment of systems for remote monitoring for implantable cardioverter defibrillators (ICD). The aim of this assessment was an update and clarification of arrangements for the provision of implantable cardioverter defibrillator systems (ICDS) to improve the quality of care for patients with ICD and to promote the deployment of effective solutions in the country.

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07

Sep 2017

In 2016, Joint Federal Committee (G-BA) commissioned Institute for Quality and Efficiency in Health Care (IQWIG) for benefit assessment of telemonitoring systems in patients with implantable cardioverter defibrillators (ICD). In July 2017, IQWIG published a preliminary report. Due to lack of evidence, no benefit statement was made.

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06

Sep 2017

French National Authority for Health (HAS) released new decisions about add-on and medical aid reimbursement of medical devices from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in August 2017. They include different types of stents and stent-grafts for multiple indications (coronary, peripheral vascular), mechanical thrombectomy devices for stroke, medical devices applied for treatment of ulcer of venous origin, remote monitoring for Implantable Cardioverter Defibrillator Systems (ICDS).

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11

Aug 2017

In the Netherlands, there is a possibility to test novel ways of delivering health care services (e.g. mobile diagnostic modules, online counselling, telemonitoring, screening/diagnostic for some complex conditions in primary care etc.) by establishing short (3 years) experiments between health provider and insurance company. After completion of experiment, analysis shall be performed about effect of the intervention. If it works, a new model can be population as novel type of care service in broader settings. See full list of ongoing small-scale experiment projects, extracted by MTRC.

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06

Jun 2017

HAS published updated program that defines priority areas of work for 2017, including evidence review as part of developing new procedure codes for robotic surgery, endoscopic procedures, and technology assessments of remote monitoring, dialysis, coronary stents and others.

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17

May 2017

Russian Government has approved draft legislation about telemedicine in the country. It covers number of elements including united information system in health care, exchange of information about stakeholders in health care, ability to perform teleconsultation, remote monitoring and to issue electronic prescriptions.

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