Open-house procedure for outpatient vein therapy

Summary

The tender concerns outpatient treatment of symptomatic varicose veins of the lower extremities for AOK Rheinland-Pfalz/Saarland members, using endoluminal laser therapy or radiofrequency ablation. The participating healthcare provider performs the necessary diagnostic examinations and assessment of the indication, carries out the procedure, and provides anaesthesia, immediate postoperative care, documentation and medically necessary follow-up for up to six weeks. The provider must also be reachable by telephone for patient questions for 24 hours after the procedure. Eligible providers must operate in the region of Rhineland-Palatinate or Saarland. This is an open-house procedure with uniform, non-negotiable terms and no limit on the number of eligible participating providers. Providers may join until 31 December 2027; the contract takes effect on 1 January 2026. Treatment is intended for AOK Rheinland-Pfalz/Saarland members aged 18 or over who have symptomatic varicose veins and meet the medical eligibility criteria. Payment is made as a fixed fee for each treatment episode. The fee depends on whether one or both legs are treated and on the number of venous territories: rates range from EUR 990 to EUR 3,168, with intermediate rates of EUR 1,584, EUR 1,683 and EUR 2,574. The fee covers, among other things, necessary materials, anaesthesia, the procedure, patient care, quality assurance, documentation and follow-up. Up to 50 treatment episodes per provider per year are paid at the full rate; a 10% reduction applies from the 51st episode. Duplicate billing and billing incompatible procedure fees on the same treatment day are prohibited. Claims are submitted electronically after completion of the treatment episode and are payable within 28 days of receipt.