In Germany, billing for medical treatments is often complex and can appear quite confusing to outsiders.
Typically, we negotiate your medical case simultaneously with several specialists and hospitals.
Although this process is time-consuming, it ensures the best possible care for the patient and saves money in each individual case — for the patient or their payer.
A brief explanation of the different billing systems in the German healthcare system can be found here:
The DRG system (Diagnosis Related Groups), used for billing medical services in German hospitals, includes a wide range of items divided into various categories and subgroups. These items cover not only physician services but also other resources and cost centers necessary for the diagnosis and treatment of a patient. The key components of the DRG system are:
Primary and Secondary Diagnoses – the main reason for the hospital stay as well as other relevant diagnoses.
Procedures – surgical interventions and other therapeutic measures performed.
Nursing Care – time and resources allocated for the patient’s nursing care.
Length of Stay – the number of days the patient spends in the hospital.
Cost Centers such as medications, materials, diagnostics (e.g., laboratory tests, imaging procedures), and therapies (e.g., physiotherapy, occupational therapy).
The DRG system classifies treatment cases into approximately 1,300 DRG categories (as of 2023), which serve as the basis for reimbursement.
Within these DRGs, numerous subcategories exist that are used for billing individual services.
In addition, there are the so-called EBM (Uniform Value Scale) and GOÄ (Fee Schedule for Physicians), which are applied for detailed billing of individual medical services and each cover hundreds to thousands of specific service items.
For in-depth information on DRG billing, several reliable sources are available:
These sources provide a reliable foundation for in-depth information, the latest versions of the DRG catalogs, and their billing procedures.
