The revised EBM (German Uniform Evaluation Standard) catalog came into force on July 1, 2020. MTRC has compiled the selection of the most significant changes.
The reimbursement of services in the public outpatient sector in Germany is regulated in the EBM catalogue (Einheitlicher Bewertungsmaßstab), updated once in a quarter (4 times a year). The adaption time frame of the EBM catalogue for a specific code is around five years but varies depending on the evidence.
The list of the most important changes in EBM for the third quarter of 2020 is presented below:
- Endoscopic single-use instruments
- The fee order item (GOP) 40460 "Flat rate in connection with the performance of the service according to fee order items 01742, 04515, 04520, 08334, 13260, 13401, 13402, 13423 and 30601 when using a single-use high-frequency diathermy snare for a polypectomy or a mucosectomy" with a tariff of €12.00 was added
- GOP 40461 "Flat rate in connection with the performance of the service according to the fee order items 01741, 04511, 04514, 08311, 09315, 09317, 13400, 13421, 13422, 13430, 13662, 26310 and 26311 when using a single-use sampling device" with a tariff of €8.00 was added
- GOP 40462 "Flat fee in connection with the performance of the service under fee order items 01742, 04511, 13400 and 13423 when using a clip including a single-use endo / hemo clip applicator", per clip with a tariff of €20.80 was added
- Kidney replacement therapy
- The GOPs 04567 "Surcharge in connection with fee order item 04562" and 13603 "Surcharge in connection with fee order item 13602" for continuous care for a patient requiring dialysis in children and adults correspondingly with a tariff of €13.18 were added
- Psychotherapeutic treatment for adults in the form of systemic therapy
- The GOPs 35431 "Systemic therapy (short-term therapy 1, individual treatment)", 35432 "Systemic therapy (short-term therapy 2, individual treatment)" and 35435 "Systemic therapy (long-term therapy, individual treatment)" with a tariff of €101.30 were added
- The GOPs 35703 "Group therapy with 3 participants" with a tariff of €100.64, 35704 "Group therapy with 4 participants" with a tariff of €84.82, 35705 "Group therapy with 5 participants" with a tariff of €75.37, 35706 "Group therapy with 6 participants" with a tariff of €69.00, 35707 "Group therapy with 7 participants" with a tariff of €64.38, 35708 "Group therapy with 8 participants" with a tariff of €61.09 and 35709 "Group therapy with 9 participants" with a tariff of €58.45 were added
- Reimbursement of trial procedures in accordance with section 137e SGB V. The following sub-chapters were included in the EBM:
- 61.1 "Trial guideline "Liposuction" with 19 new GOPs
- 61.2 "Trial guideline "Tonsillotomy" with 12 new GOPs
- 61.3 "Trial guideline "MRgFUS-TUF" concerning magnetic resonance image-controlled, highly focused ultrasound therapy for the treatment of uterine fibroids with three new GOPs
- 61.4 "Trial guideline "MM-pul-art-Druck-Herzinsuff" concerning the measurement and monitoring of pulmonary artery pressure using an implanted sensor to optimize therapy for heart failure in stage NYHA III with five new GOPs.
The latest version of EBM can be accessed here.
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