Co-payments
Most recently, the subsidy rates for therapeutic products were increased on 1 January 2022 for state and federal employees. No increase in aid rates has been announced for 2023. For the first time, the subsidy rates in 2023 will be significantly lower than the fee rates paid by the statutory health insurance funds (AOK, DAK, TKK, etc.) for physiotherapy. For the subsidy patients, this means higher co-payments in the future. It is important to understand that not private and subsidy insured pay a surcharge, but patients with statutory health insurance receive a quantity discount. This is regulated in the framework agreement pursuant to §125 Abs. 1 SGB V with the statutory health insurance funds.
Federal-Aid not full coverage
The aid rates are not equivalent to maximum charges for physiotherapy. The aid-payment is only a co-payment of the employer for the health care of state or federal employees at the private carges of the facility. They are free to set their charges and agree or coordinate them with the client. The legislator assumes for subsidized patients of a co-payment in a similar amount as for legally insured persons (they pay 10, - Euro per prescription plus 10% of the treatment fee). It should be noted that civil servants also have to pay significantly cheaper monthly premiums.
Pricing
Practice owners must calculate fees according to economic criteria and can set them at their own discretion up to 3.5 times the local fee.