Telemonitoring for heart failure: remuneration & billing
Telemonitoring for heart failure: remuneration & billing
New items in the EBM and GOÄ regulate the billing of telemonitoring for heart failure for patients with private and statutory health insurance. Calculate your maximum remuneration as a cardiologist now with our remuneration calculator.
Table of contents
With the Telemonitoring in heart failure billing of new services via the EBM has been possible for panel doctors since January 2022.
For private doctors, the German Medical Association and the German Association of Statutory Health Insurance Funds (PKV) have established joint billing recommendations for telemonitoring in chronic heart failure. Since January 2024, billing is therefore also possible according to the GOÄ.
Information on billing according to the GOÄ can be found on the Homepage of the PKV.
EBM: The GOPs in detail
If you exhaust all possibilities, you can maximum 1.356,24 € per patient:in/year bill. This figure results from the following fee schedule items in the EBM:
Power
Remuneration
GOP 13583: Guidance and education of patients on telemonitoring
10,92 € (95 points, 1x per year)
GOP 40910: Flat rate for the required basic equipment with external measuring devices
68,00 € (1x per quarter)
GOP 13586: Telemonitoring in heart failure using external measuring devices
241,32 € (2,100 points, 1x per quarter)
GOP 13587 (optional): Surcharge to GOP 13586 for intensified telemonitoring on weekends and public holidays
27,01 € (235 points, 1x per quarter)
Calculate now: Your possible remuneration
Your specific remuneration depends on the services you provide as a cardiology practice within the framework of telemonitoring, as well as on the number of your heart failure patients who use the medical preconditions for telemonitoring.
The billing recommendations according to the GOÄ
Joint billing recommendation of the German Medical Association (BÄK), the Association of Private Health Insurers (PKV-Verband) and the organisations responsible for costs in cases of illness, nursing care and childbirth in accordance with federal and state civil service regulations on telemonitoring for chronic heart failure:
Power
Remuneration
analogue number 33 GOÄ : Instruction and education of patients on the basic principles of telemonitoring, the use of the devices used and self-management
Fee at 1.0/2.3/3.5 times the rate: EUR 17.49/40.22/61.20
The service is billable once at the start of treatment
analogue number 551 GOÄ: Data acquisition, analysis and viewing of any alerts that occur (data management) using cardiac units telemetrically
transmitted data as part of telemonitoring for chronic heart failure, per calendar day
Fee at 1.0/1.8/2.5 times the rate: EUR 2.80/5.04/6.99
analogue number 600 GOÄ: Data acquisition, analysis and viewing of any warning messages (data management) using external telemetric measuring devices
transmitted data as part of telemonitoring for chronic heart failure, per calendar day
Fee at 1.0/2.3/3.5 times the rate: EUR 4.25/9.79/14.89
according to No. 60 GOÄ: Consultative discussion of alerts and the associated measures and/or patient-specific discussion between
the physicians involved in telemonitoring, including the corresponding documentation, per participating physician
Fee at 1.0/2.3/3.5 times the rate: EUR 6.99/16.09/24.48
The service according to No. 60 GOÄ is not billable if the doctors belong to the same medical telemedicine centre (TMZ).
Technical and regulatory requirements
When calculating their expected revenue, cardiologists must offset the effort and costs incurred by telemonitoring. Regulatory and technical requirements in particular must be taken into account here.
You essentially need 3 things:
- an accreditation as a telemedicine centre (TMZ)
- a telemonitoring software (e.g.: SaniQ HERZ)
- External measuring devices for the patients
With the telemonitoring software SaniQ HEART:
- we offer you the most attractive price model on the market
- fulfil all technical, regulatory and data protection requirements
- you and your patients receive comprehensive technical support
Source:
Kassenärztliche Bundesvereinigung & GKV-Spitzenverband: Quality Assurance Agreement Telemonitoring in Heart Failure. 2022.
Heart failure monitoring.
Finally made easy with SaniQ HERZ
Digital heart failure monitoring.
Finally made easy with SaniQ HERZ
- State-of-the-art sensor technology
- New, simplified patient app
- the most attractive price model on the market
These articles might be of interest to you:
Cardiac telemonitoring for heart failure
Cardiology practices have been able to bill for cardiac telemonitoring in heart failure since 2022. We will show you how you can meet the requirements and offer your patients modern care.
Case study: Telemonitoring prevents cardiac decompensation
A concrete case from a cardiological group practice in Krefeld shows how telemonitoring of important vital signs and direct communication with patients can help to identify and treat critical events at an early stage.
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