In April 2020, the Belgian National Institute for Health and Disability Insurance (INAMI-RIZIV) introduced four new nomenclature codes for stereotactic radiotherapy (Belgian Monitor of April 27, 2020). Physicians also must register data on provided stereotactic radiotherapy series in the specific module of Cancer Registry Foundation.
New services belong to a category 4-bis of the INAMI nomenclature of health services for radiotherapy (article 18 §1 and article 19).
- 444636-444640 Fixed fees for a series of stereotactic radiotherapy in a patient who meets the criteria in category 4bis, with primary tumors (except brain tumors)
- 444651-444662 Fixed fees for a series of stereotactic radiotherapy in a patient who meets the criteria in category 4bis, with oligometastases (except brain metastases)
- 444673-444684 Fixed fees for a series of stereotactic radiotherapy in a patient who meets the criteria in category 4bis, with malignant brain tumors and brain metastases
- 444695-444706 Fixed fees for a series of stereotactic radiotherapy in a patient who meets the criteria in category 4bis, with non-malignant brain tumors and arteriovenous malformations (AVM)
Each of these services is remunerated at K 2000 (actual tariff is € 2,581.73)
The reimbursement conditions include registration data in the Cancer Registry Foundation. Personal data will be kept for 30 years after the patients' death. The purposes of this register are:
- Quality control and monitoring of the costs of the care provided
- Long-term prospective monitoring of mortality, recurrences and secondary cancers in order to assess and adapt the national policies
A multidisciplinary recommendation for this radiotherapy technique is required prior to each treatment series. It is a complex external irradiation with at least 6 Gy per fraction, which allows affecting the lesion with high precision.
The location of the irradiated lesion can be intracerebral or extracerebral. Stereotaxic radiotherapy to treat extracerebral lesions - primary tumors and - oligometastatic lesions (maximum of five lesions)
A maximum number of services that can be applied to one patient:
- Three series of stereotactic radiotherapy for a patient, per 12 months and per organ
- In total six times per 12 months for the whole body (including the brain)
Only one series of treatments can be invoiced per brain treatment procedure regardless of the number of lesions.
See the full details here.
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