The Federal Joint Committee has recognized the relevance of cold plasma therapy and confirmed this by initiating a trial study. However, the classification of the CPT®patch in the SHI benefits catalog has not yet been conclusively clarified.
It is conceivable that the CPT®patch can be classified as a dressing and can therefore be dispensed without further ado in accordance with the known principles of the economic efficiency requirement.
However, it is also conceivable that it is to be classified as another wound care product or as part of a new method and can therefore currently only be dispensed if approved by the health insurance company.
In this situation, it is advisable to have the health insurance company expressly confirm in writing that it recognizes its obligation to provide benefits in advance of dispensing the CPT®patch in order to protect against retaxation.
For the confirmation of the obligation to pay benefits to be declared to the insured person, it makes sense for the treating physician to explain the individual severity of the illness and, above all, the unsuccessful exhaustion of all more cost-effective alternatives and the available evidence.