The basis for billing is the Fee Schedule for Physicians (GOÄ). There, performance-related billing codes are listed. The GOÄ is issued by the Federal Government with the consent of the Federal Council. However, the current version has not been relevantly adapted in the last 25 years and still contains prices in DM, which have been converted as a makeshift solution (see German Bundestag, Scientific Services: The Fee Schedule for Physicians). The conversions are still noticeable today in the form of curved prices. The Fee Schedule provides for an increase in the fee rate depending on the claim of the treatment and the effort. When considering how rents, energy costs, small materials, and personnel costs have developed over the last 30 years, it becomes clear that these costs should already be considered as additional "effort" compared to 1995. The revision of the GOÄ has been going on for years between the medical profession, cost bearers, and the Ministry of Health, but has not yet been successfully completed. In particular, the consultation, which is particularly important to us, is unfortunately completely undervalued in the current GOÄ.
We would like to provide you with a rough overview of the actual costs for the practice operation from transparency, so that you can understand the amounts we earn from billing according to GOÄ at the end.
| Investments | Amount |
|---|---|
| Renovation of the rooms | 200,000 € |
| Furniture (excluding beds and etc.) | 58,000 € |
| Equipment (including medical products and IT) | 63,500 € |
| Consumable materials (initial equipment) | 8,000 € |
| Other costs | 6,500 € |
| Total investment | 336,000 € |
| Plus interest at repayment over 20 years | 165,000 € |
| Annual cost allocation after 20 years of operation |
25,050 €/a |
When allocating the investment costs over 20 years of operation, it is not yet taken into account that individual equipment items (in particular computers and medical devices) may need to be replaced more quickly, and that the walls may need to be repainted in the meantime.
In ongoing operation, there are additional costs such as rent (plus electricity, water, heat), insurance, internet and practice software costs, and above all personnel costs.
| Expense group | Costs |
|---|---|
| Investments (s. o.) annual allocation | 25,050 €/a |
| Operating costs per year | 50,000 €/a |
| Personnel costs per year | 280,000 €/a |
| Annual costs | 355,000 €/a |
| Costs per consultation in full-time operation* |
273 €/h |
So we have costs of around 273 €/h, i.e. 4.55 €/Minute. A typical 30-minute consultation should therefore earn around 136 € to cover the costs. Only when we exceed this amount does the practice start to become economically viable.
In your bill, you will first find the information about the patient / patient and then the diagnoses including the coding according to the International Classification of Diseases (ICD) in the version 10 valid in Germany (GM = German Modification / German adaptation), see also ICD-10-GM. Then follow the billing codes according to the GOÄ and finally the material costs, which are not included in the inclusive articles. For further information on the billing codes of the Fee Schedule for Physicians, please see the Internet, e.g. on the website of private health insurance companies: GOÄ