GOÄ Number 21: the thorough genetic counselling service

The service text of Number 21

„Eingehend“ — thorough — stands in the service text of Number 21 too, as it does in Number 3, here referring specifically to human genetic counselling. Unlike Number 3, though, billing here is not a flat fee: it follows the unit „je angefangene halbe Stunde und Sitzung“, by which the service text itself ties how many times the service is billed to the duration and to the session.

A separate provision also sets a minimum duration for the session: if the counselling does not reach it, the service under Number 21 may not be billed. That is a condition standing alongside the service description itself, not inside it.

A second provision speaks of the „Beratungsfall“ — a term the fee schedule does not itself define at this point. The word differs from the Behandlungsfall, which the Allgemeine Bestimmung to Abschnitt B describes as the period of one month after the patient's first attendance for the same illness; what begins the Beratungsfall and how long it runs, the ordinance does not say here.

The exclusion is mutual: alongside Number 21, Numbers 1, 3, 4, 22 and 34 are not billable, and alongside Number 22 in turn, Number 21 is not billable. Number 22 itself is not a page in this lexicon; it appears here only inside the quoted provision.

The multiplier for Number 21

Number 21 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.

For this number too, criteria for assessment are already named in the service text: that the counselling is thorough, and that it is billed „je angefangene halbe Stunde und Sitzung“, plus the minimum duration of the session named in the provision. Under § 5 Abs. 2 Satz 3 GOÄ, criteria 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 21

Because the service is billed „je angefangene halbe Stunde und Sitzung“, the record must show, for every session, the number of units reached — not just that counselling took place, but how many times the unit was reached.

Because the provision limits billing „innerhalb eines halben Jahres nach Beginn des Beratungsfalls“ to four times, the record must also state when the Beratungsfall began — otherwise that limit cannot be traced later.

§ 630f BGB requires the essential measures and their results, from a professional standpoint, in immediate temporal connection with the treatment. For human genetic counselling, that includes what was discussed in the session, not just its duration.

Read on