GOÄ Number 20: the group consultation for chronic illness

The service text of Number 20

The group size stands in the service text itself: 4 to 12 participants, no fewer and no more. A consultation held with three people, or with thirteen, is not a group consultation under Number 20 — the line is drawn in the wording, not in an interpretation.

„Je Teilnehmer und Sitzung“ means the fee arises anew for each participant and for each session. It is not a flat fee for the group as a whole, but a fixed rate per person and appointment.

„Im Rahmen der Behandlung von chronischen Krankheiten“ sets the occasion for the group. What counts as a chronic illness for the purposes of this number, the fee schedule does not define; it assumes the term without narrowing it.

The service text also names a minimum duration per session, in parentheses after the description. As with other numbers in this section, that minimum duration is part of the service description itself, not a separate condition.

The multiplier for Number 20

Number 20 stands in Abschnitt B, so it falls within the ordinary fee range: from the single rate up to the 3.5-fold rate, with the 2.3-fold rate as the span within which, under § 5 Abs. 2 Satz 4 GOÄ, a fee is as a rule assessed.

Several criteria for this number are already named in the service text itself: the group size of 4 to 12 participants, billing per participant and session, and the minimum duration. Under § 5 Abs. 2 Satz 3 GOÄ, criteria for assessment already accounted for in the service description are left out of consideration — they do not by themselves carry an increase.

Above the 2.3-fold rate, § 12 Abs. 3 GOÄ applies: written, tied to the particular service, comprehensible and traceable for the person liable to pay, and to be explained further on request.

What the record has to carry for Number 20

Because the fee arises per participant and session, the record must show, for every session, who took part. A collective note for the group does not carry the individual billing.

§ 12 Abs. 2 Nr. 2 GOÄ expressly requires the invoice to state „einschließlich einer in der Leistungsbeschreibung gegebenenfalls genannten Mindestdauer“ — including any minimum duration named in the service description. An invoice can only carry that statement if the duration of the session was recorded.

§ 630f BGB requires the essential measures and their results, from a professional standpoint, in immediate temporal connection with the treatment — for a group session that means the content and the circle of participants, not just the appointment itself.

Read on