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Physicians and psychotherapists who prescribe digital health apps (DiGA) will receive retroactive extrabudgetary remuneration for their services as of January 1, 2021. According to a decision of the Extended Evaluation Committee (EBA), treatments of persons over 18 years of age are additionally reimbursable, but not services for children and adolescents, because they are not allowed to be prescribed digital health apps.

The prerequisite for the additional reimbursement is that the DiGa must be listed in the directory of the Federal Institute for Drugs and Medical Devices (BfArM). The prescription must be made by drug prescription and the fee schedule item (GOP) 01470 (2 euros/18 points) must be indicated. The prescription must also be made in the context of a telemedical consultation. If more than one DiGA is prescribed, the individual must be named and can then be billed multiple times. The period for the introductory phase of the DiGA prescription will initially run until December 31, 2022.

The EBA also decided, after the GKV-Spitzenverband and the Kassenärztliche Bundesvereinigung (KBV) presented different reimbursement concepts, that the web application called Somnio for sleep onset and sleep through disorders should be additionally reimbursed at 7.12 euros/64 points under GOP 01471, but not the DiGA „Velibra“ for anxiety disorders and panic attacks. Velibra has not been listed in the BfArM directory and is therefore not reimbursable if the patient was treated via video consultation.

The GKV-Spitzenverband and KBV each had to submit to the EBA’s concept after deliberations on differing opinions. This compromise worked out by the EBA has been binding since March 17, 2021 and is effective retroactively. Services that are not part of the standardized evaluation scale (EBM) will not be additionally reimbursed, as the example of „Velibra“ shows.

Thanks to the Digital Health Care Act, patients are entitled to health apps that have been assigned to low-risk classes as medical devices. They offer good support for patients if practitioners believe that the „apps on prescription“ in the therapy process detect, monitor and improve diseases.

Source: www.aerzteblatt.de