PET/CT-Costs in the DTZ

Due to the widely varied and constantly fluctuating progressive situation of the financing of PET/CT services, at this point there should be a short overview regarding the principle possibilities of the absorption of costs according to insurance relationships given.

1. Health insurance patient

Public health insurance

At the moment, the PET(/CT) for non-small cell lung cancer and cancer of the lung nodule is reimbursed by public health insurance companies. You can find the relevant regulations on the Federation of Community Boards website(G-BA).

In order to register successfully with the DTZ, both a letter of referral and a declaration from your health insurance to cover costs are required. Appointments are booked by telephone.

In the case of other indications the taking over of costs is at the moment not regulated, in specific cases this is however possible and to be clarified in advance with your insurer. In the case that costs would not be covered, an IgeL-agreement can be reached. With this in mind, we recommend a free counseling interview in our practice beforehand.

Payment can be made with an ec-card or in cash.

Techniker Krankenkasse (Technician health insurance company) (TK)

For some considerable time now with the Techniker Krankenkasse (TK), there has been a contract of collaboration in the area of bronchial cancer in cooperation with the HELIOS-Clinic „Emil von Behring“. Those insured with the TK are provided with medically sensible PET/CT examinations ascertaining the stage of tumour and the establishment of therapeutic procedure (operative procedure, chemotherapy, radiotherapy).

As of 01.12.2007, based on positive experience, this health insurance company has admitted two further diseases, breast cancer and lymph gland cancer, into services refunded for those insured.

You can gather details from the press release (insert link). Collaboration over these two diseases is in place with declared experts of the Charité „Benjamin Franklin“ campus and the Lichtenberg Sana clinic, as well as practices with a core outpatient emphasis.

Those insured with the TK should pay attention to the following in particular: The participation in the examination program is of one´s own free will. In order to participate, the patient simply has to sign a declaration. All costs will then be cleared by the TK. Data yielded will be scientifically evaluated anonymously. There are no further obligations.

2. Hospital patient

Hospital patients can be registered for examination by the attending institution and will be thus not charged. The hospital receives an invoice amounting to an IgeL-bill.

3. Individual health service (IGeL)

An individual health service is an agreement between patient and doctor about a medically sensible method that is not currently listed in the public health insurance catalogue of reimbursements. The calculation of costs is made under the terms of the GOÄ. The necessity of such a method should be clarified in a preliminary talk.

4. Private patient

PET has been accepted for more than 10 years as a service covered by private health insurance policies. The bill our practice invoices is made out under the terms of GOÄ, in accordance with the recommendations of the Professional Association of German Nuclear Medical Practitioners (BDN).

A referral from the attending house doctor or oncologist is advisable in order to ascertain the medical needs as obliged. Previous findings are welcome.

5. Foreign patients

Foreign patients are in principle treated in the same way as our German private patients and receive a private-care bill under the terms of GOÄ.