The Corona warning app, developed on behalf of the German government, has been available for download in the Google and Apple stores since June 16, 2020. It is intended to help identify and break infection chains at an early stage. Users of the app receive a notification if they have been for a long time in the vicinity of a person who was later found to be infected with the coronavirus.
At the launch of the Corona warning app, the National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV) have added several new services to the EBM (German Uniform Evaluation Standard) and regulated the reimbursement to compensate for the smear collection and the laboratory testing. As of now, doctors can bill these services for insured persons who come to the practice for a test after the app has warned them. Thereafter, contracted doctors will receive €10 extra for the smear collection together with the basic or insured flat rate.
The smear collection is reimbursed via the new fee order item (GOP) 02402 "Upper airway swab collection (oropharynx and/or nasopharynx smear, irrigation or aspirate)" (Abstrichentnahme aus den oberen Atemwegen (Oropharynx und/oder Nasopharynx-Abstrich, -Spülung oder -Aspirat)) (91 points / €10). It is billable once on the day of treatment and only for insured persons who referred because of an app warning. Smears collection for insured persons with symptoms is still part of the insured or basic flat rate.
There are also new services in EBM for laboratory tests performed due to warnings from the app, including:
- GOP 32811 “Nucleic acid of the SARS-CoV-2 coronavirus detection due to a warning by the Corona warning app” (Nukleinsäurenachweis des Coronavirus SARS-CoV-2 aufgrund einer Warnung durch die Corona-Warn-App) (€39.40) for nucleic acid detection
- GOP 12221 (14 points / €1.54) for medical services
- GOP 40101 “Surcharge for fee order item 32811 in case of sending samples for shipping material, shipping containers, etc., as well as for sending or transporting test material, possibly also infectious test material, including the costs for the submission of test results” (Zuschlag zur Gebührenordnungsposition 32811 bei Probeneinsendung für Versandmaterial, Versandgefäße usw. sowie für die Versendung bzw. den Transport von Untersuchungsmaterial, gegebenenfalls auch von infektiösem Untersuchungsmaterial, einschließlich der Kosten für die Übermittlung von Untersuchungsergebnissen) (€2.60) for the reimbursement of the costs for transport and submission of the test results.
The new GOPs 02402, 32811, 12221 and 40101 can only be billed in connection with the notification of an "increased risk" of the new Corona warning app if the insured person visits a contracted doctor directly.
According to the Robert Koch Institute information, the number of Corona warning app installations reached 10.6 million as of June 20, 2020.
The full details in German can be found here. The corresponding decision of the Evaluation Committee in German can be found here.
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