Reimbursement

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the December 2024 meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Three favorable opinions were published concerning the registration of new medical devices in the List of Reimbursable Products and Services (LPPR). They relate to breast reconstruction and medical aids.

On January 1, 2025, the revised EBM (German Uniform Evaluation Standard) catalog for the first quarter of 2025 came into force. The main changes introduced concern updates of the contents (services legends, preambles of several EBM subchapters), the introduction of new EBM codes related to dialysis services, CT coronary angiography, management of long COVID patients, different types of consultations and visits, and material costs flat rates related to shipping services.

On December 19, 2024, the Dutch Healthcare Institute (ZIN) published the updated list of medical procedures reimbursed under basic health insurance with restrictions or limitations. The procedures have the so-called "claim" codes (aanspraakcodes). The Dutch Healthcare Authority assigns the "claim" codes based on positions published by the ZIN. The changes included the introduction of one new procedure code.

On December 19, 2024, the Hybrid DRG reimbursement agreement for 2025 was published. It determines which interventions will be reimbursed via a hybrid DRG mechanism and the associated tariffs. The newly introduced DRGs mainly belong to the endoscopy, gastrointestinal, and men’s health fields.

On December 12, 2024, the entity managing the DRG system in Switzerland, SwissDRG, published the final (billing) version of the 2025 DRG system. In total, 23 new DRGs related to cardiovascular, gastrointestinal, nephrology and urology, neurology and neurosurgery, obstetrics and gynecology, orthopedics, pulmonary and airways, and some other areas were introduced. Also, 17 new add-on reimbursement categories were implemented.

In late November – early December 2024, the application period for 2026 ICD-10-GM (German modification of ICD-10 diagnosis codes), OPS (procedure codes), and DRG changes was opened by the Federal Institute for Drugs and Medical Devices (BfArM) and the Institute for Hospital Remuneration Systems (INeK), respectively.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the November 2024 meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS). Two recommendations were published concerning the registration of new medical devices in the List of Reimbursable Products and Services (LPPR). Opinions were related to breast reconstruction and medical aids.

On November 12, 2024, the Danish Health Data Authority published the DRG tariffs for 2025. In accordance with the released documentation, four new DRGs in the fields of radiology, dermatology, and the treatment of functional disorders will be introduced in 2025.

In mid-November 2024, a new version of the classification of procedure codes (CCAM v.77), effective from January 1, 2025, was published. No new codes were introduced. The main changes concerned the tariff rules for procedures and their applications for doctors, as well as the modification of tariffs for 31 dental procedures.

On November 17, 2024, the French Ministry of Health and Access to Care published an Order in the Official Journal of the French Republic on the support and reimbursement of reinforced care pathways – a direct outcome of the experimental projects under Article 51 of the Social Security Financing Act of 2018, which aimed to innovate healthcare delivery and financing models. The new framework aims to enhance the coordination and quality of care for patients with complex health needs and provides financing for coordinated care projects.

On November 14, 2024, the State-Regions Conference approved the Decree with the new national LEA tariffs for outpatient specialist care and prosthetic care presented by the Italian Ministry of Health. The effective date of new tariffs is December 30, 2024.

The French National Authority for Health (HAS) released new recommendations about add-on reimbursement of medical devices and medical aids from the meetings of the National Commission for Evaluation of Medical Devices and Health Technologies (CNEDiMTS) in October 2024. Ten recommendations were published concerning the registration or modification of registration conditions/extension of indications for the medical devices in the List of Reimbursable Products and Services (LPPR). Opinions concern cardiovascular, peripheral vascular, neurovascular, and interventional radiology devices, as well as medical aids.