GOÄ - The scale of fees for doctors simply explained
The GOÄ regulates the remuneration of medical services for private patients. Find out how it works, when it applies and what differences there are to statutory health insurance.
Things worth knowing about "GOÄ"
(Gebührenordnung für Ärzte) is the legal basis for the billing of medical services outside the statutory health insurance, in particular for private patients, self-payers and those entitled to benefits.
The GOÄ regulates exactly how much a doctor may charge for certain services, based on a fee schedule with over 2,000 individual services, which is standardised throughout Germany. The GOÄ thus represents the counterpart to the EBM (Einheitlicher Bewertungsmaßstab) which applies to those with statutory health insurance.
Each medical service in the GOÄ is assigned a point value which is multiplied by a multiplier (usually 1.0 to 3.5 times, in medically justified cases even higher) and a fixed euro base value is multiplied. This results in the specific invoice amount. The GOÄ allows doctors to take individual factors such as time required, difficulty or special circumstances into account, which can lead to higher reimbursement amounts compared to the health insurance billing.
The GOÄ applies not only in doctors'll urgeries, but also in hospitals for privately insured patients, for IGeL services (individual healthcare services) and for certain naturopathic or aesthetic treatments. A revision of the GOÄ has been under discussion for years, as many billing rates are outdated and modern medical services are not adequately reflected. Nevertheless, the GOÄ remains a central control instrument in the dual healthcare system.
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