Declaration Rules 2025
What is the situation regarding the declaration rules for 2025?
There is a legal basis requiring that a healthcare invoice must include specific details that allow the health insurer to verify the invoice. This specifically concerns the mention of the so-called DSM main group diagnoses and the gb-ggz profile on healthcare invoices.
Since early 2025, there has been a debate about the way healthcare services can be declared. This discussion arose because, as of this year, the NZa has removed the requirement to include DSM main group codes and gb-ggz profiles on healthcare invoices. However, health insurers still need this information to verify invoices. Additionally, these details are essential for the proper functioning of risk equalization.
The Ministry of Health, Welfare, and Sport (VWS) expects that by April 2025, a regulation will be in place to resolve this discussion.
How does Psychiatrie Noord handle this discussion?
Psychiatrie Noord believes that there is still a legal basis for including the aforementioned details on healthcare invoices. The Ministry of VWS confirms, based on advice from the State Advocate, that the registration of DSM main group diagnoses and gb-ggz profiles, as well as their transmission to health insurers, does not pose any legal risks.
For Psychiatrie Noord, it is essential that healthcare services are declared to health insurers on a monthly basis. If this does not happen, there is a risk to the continuity of care. Additionally, the administrative burden of having 3,500 patients sign a consent form is too great for Psychiatrie Noord.
We refer to the website:
Health insurers offer emergency solutions after concerns about GGZ declaration rules – Zorgverzekeraars Nederland
We refer to the parliamentary letter:
Parliamentary letter
If you have any questions about the policy of Psychiatrie Noord, you can contact us at info@psychiatrienoord.nl.
