Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

56 Hyperbaric Oxygenation Therapy KCE Reports 74
For diving accidents, some centres do not charge the RIZIV/INAMI but send the bill to
the patient who then reclaims the money from the sports insurer.
5.2.2.4 Nomenclature for the military hospital
The Military hospital Queen Astrid is not under the jurisdiction of the Hospital law. As
a result, even though this military centre also provides services to citizens, the above
mentioned nomenclature does not apply to it. For their ambulatory patients, i.e. the
majority of their patients, there is no invoicing to RIZIV/INAMI. For hospitalized
patients, however, a Ministerial Decree of February 4th 1999 b provides an invoicing
code covering the hospitalization, treatment and care, pharmaceutical products, other
supplies and the medical-technical acts for patients treated with hyperbaric oxygen (see
Table 12). This invoicing code does not cover the installation of and supervision on
oxygen therapy in the hyperbaric chamber. For this specific act, and similarly for
ambulatory patients, there is no invoicing to the national insurer.
Table 12. Fee-for-service code for the military hospital
Code Amb/Hos Definition
760642 Hosp Hospitalization at the military hospital, patient day price for hospitalization
required for treatment with oxygen therapy in hyperbaric chamber
Amb: ambulatory; Hosp: hospitalized
Source: https://www.riziv.fgov.be/webapp/nomen/ (accessed on 29 November 2007)
5.3 CURRENT RIZIV TARIFF
5.3.1 RIZIV/INAMI tariff level
On January 1, 2008, the HBOT tariff level for both hospitalized and ambulatory patients
was set at €64.63 (N96) and €48.47 (N72) for the first and second treatment day,
respectively. As mentioned previously, there is no fee for consecutive treatments.
5.3.2 RIZIV/INAMI reimbursement level
The reimbursement level is 100% of the tariff for both the first and second day of
HBOT treatment, for this procedure there is no invoicing to the patient.
5.3.3 RIZIV/INAMI military hospital fee
For the military hospital, the per diem fee for a patient receiving HBOT is €712.54
(January 1, 2008).
5.4 RIZIV/INAMI EXPENDITURES FOR HBOT IN BELGIUM
The expenditures for HBOT by the national health insurance are relatively small. In
2006, about €83 000 was paid (Figure 23), for approximately 1 400 sessions (Figure 24),
less than 9% of more than 16 400 sessions given during that year (see section 5.7.1).
b MB (Ministerieel besluit) van 4 februari 1999 tot vaststelling van de tegemoetkoming van de verplichte
verzekering voor geneeskundige verzorging en uitkeringen in de verpleegdagprijs van een opneming in de
dienst van het Militair Hospitaal te Brussel die speciaal is uitgerust voor de behandeling met
zuurstoftherapie in hyperbare drukkamer.
AM (Arrêté Ministériel) 4-2-1999 - intervention dans le prix de la journée d'entretien d'une admission
dans le service de l'Hôpital Militaire à Bruxelles spécialement équipé pour le traitement par
oxygénothérapie en caisson hyperbare.