If you are covered by a type of private health insurance (e.g. incoming private health insurance such as expat health insurance or full private health insurance) or if you have a supplementary insurance (e.g. dental insurance), then learning about the GOÄ & GOZ schedule of fees will be relevant and valuable to helping you understand and navigating the German health care system.

In Germany, there is a so-called "Fee Schedule for Dentists & Doctors (GOZ & GOÄ)."

Within these fee schedules you can find a code (or 'Ziffer' in German) and a base rate cost for every treatment or service offered by doctors and dentists in Germany.

For example: The treatment of a large wound including applying stitches is billed under the GOÄ code/Ziffer '2004'. The base rate (which is 1.0) for this treatment in Germany is €13.99.

In short, yes. If a doctor or dentist feels that the particular treatment or service was more difficult than usual, they can apply a 'severity factor' (or 'Steigerungsfaktor' in German) to it.

The more difficult the treatment, the higher the severity factor. Typical severity factors fall between 1.0 and 3.5, but it is possible for your doctor or dentist to apply a factor outside of these limits.

Let’s say for example that a treatment has a base rate (1.0) of 10 euros. If a doctor or dentist then applies a severity factor of 2.0, then the cost of this treatment would now be €20.

After you have an appointment with a doctor or dentist in Germany, they must invoice you for the appointment and include the following information in the official and final invoice:

You can find an example below of an invoice with this information included:

Most insurance plans will cover 100% of the base rate (severity factor of 1.0) and only award a partial reimbursement for higher severity factors. It’s important to review your policy limits to see how much your specific plan covers.

For our full private health insurance:

On our basic private health plan, most services will be covered up to 3.5 times the base rate, however there are some services that will only be covered up to 2.3 times the base rate.

On our premium plan, there is no limit to the reimbursement, but severity factors above 3.5 require a written reason for exceeding that and submission to the service provider.

For our expat health insurance:

Our expat health plans will cover 2.3x the base rate for personal medical services. You can see a breakdown below of the reimbursement you may expect on your expat health plan based on the maximal reimbursable amount from your insurance:

It is not always possible for a doctor or dentist to know in advance what the severity/difficulty of a service may be, however, you can ask for a quote ('Kostenvoranschlag') and, in many cases, they should be able to provide you with an estimate of the services and expected costs.

Additionally, if a severity factor will be above a certain number for a given treatment or assessment, then, by law, your treating doctor is required to provide you with a written statement explaining why this is and that needs a signature of your consent before proceeding with the treatment. This statement is required for the following:

If you have any further questions, please don't hesitate to contact us.