GOÄ 55B IV — Visiten, Konsiliartätigkeit, Besuche, Assistenz500 points

GOÄ Number 55: accompanying a patient to hospital treatment

Fee

67,03 €500 points × 5,82873 Cent × 2,3

The point count stands as written in the Gebührenverzeichnis; the point value stands in § 5 Abs. 1 Satz 3 GOÄ. The amounts are computed from these and rounded to the cent, as § 5 Abs. 1 Satz 4 requires. Which multiplier is appropriate in an individual case is set by § 5 Abs. 2 according to difficulty, time taken and the circumstances of performance — the practice decides that, not this table.

Service text

„Begleitung eines Patienten durch den behandelnden Arzt zur unmittelbar notwendigen stationären Behandlung - gegebenenfalls einschließlich organisatorischer Vorbereitung der Krankenhausaufnahme -“

Not alongside — per the Gebührenverzeichnis (7)

Numbers the fee schedule names together with this one in an exclusion sentence. Open a chip for the wording, in German, and where it stands; about a particular case the sentence says only what it says.

Number 55 values the accompaniment of a patient by the treating physician to hospital treatment that is immediately necessary at 500 points. That gives 29,14 € at the single rate and 67,03 € at the 2.3-fold rate, the usual span for this number. The service text includes the organisational preparation of the hospital admission where it takes place, and the provision excludes three further numbers alongside it.

The service text of Number 55

The parenthetical „gegebenenfalls einschließlich organisatorischer Vorbereitung der Krankenhausaufnahme“ — where applicable including organisational preparation of the hospital admission — counts the organisational preparation of the admission as part of the same service where it takes place, not as a separate number alongside it.

The word „unmittelbar“ — immediately — ties the accompaniment to the necessity of the hospital treatment; the service text assumes this connection without describing it further itself.

The provision for Number 55 excludes three numbers alongside it: 56, 60 and 833. A physician who accompanies a patient cannot, for the same attendance, additionally bill the waiting time under Number 56, the consultation between physicians under Number 60, or Number 833.

Two further sentences from Abschnitt B V name Number 55 in connection with surcharges: the Allgemeine Bestimmung for the surcharges E to K 2 counts it among Numbers 45 to 55 and 60, for which the surcharges are billable only once per attendance of the physician. Zuschlag K 2 names Number 55 specifically among the services it is added to for children up to the completed 4th year of life.

The sentences below stand exactly like this in the Gebührenverzeichnis — one directly under Number 55, two from the Allgemeine Bestimmungen for the surcharges in Abschnitt B V, and two as Allgemeine Bestimmungen to Abschnitt B. They are quoted here in German, word for word rather than summarized, because the German wording is what is legally binding. The English text after each dash is a working translation, not a substitute for the statutory wording.

„Neben der Leistung nach Nummer 55 sind die Leistungen nach den Nummern 56, 60 und/oder 833 nicht berechnungsfähig.“ — Alongside the service under Number 55, the services under Numbers 56, 60 and/or 833 are not billable.
„Die Zuschläge nach den Buchstaben E bis J sowie K 2 sind nur mit dem einfachen Gebührensatz berechnungsfähig. Abweichend hiervon sind die Zuschläge nach den Buchstaben E bis H neben der Leistung nach Nummer 51 nur mit dem halben Gebührensatz berechnungsfähig. Im Zusammenhang mit Leistungen nach den Nummern 45 bis 55 und 60 dürfen die Zuschläge unabhängig von der Anzahl und Kombination der erbrachten Leistungen je Inanspruchnahme des Arztes nur einmal berechnet werden. Im Zusammenhang mit Leistungen nach den Nummern 100 oder 101 dürfen die Zuschläge nach den Buchstaben F bis H unabhängig von der Anzahl und Kombination der erbrachten Leistungen je Inanspruchnahme des Arztes nur einmal berechnet werden. Neben den Zuschlägen nach den Buchstaben E bis J sowie K 2 dürfen die Zuschläge nach den Buchstaben A bis D sowie K 1 nicht berechnet werden.“ — The surcharges under letters E to J and K 2 are billable only at the single fee rate. By way of exception, the surcharges under letters E to H are billable only at half the fee rate alongside the service under Number 51. In connection with services under Numbers 45 to 55 and 60, the surcharges may be billed only once per attendance of the physician, regardless of the number and combination of services performed. In connection with services under Numbers 100 or 101, the surcharges under letters F to H may be billed only once per attendance of the physician, regardless of the number and combination of services performed. Alongside the surcharges under letters E to J and K 2, the surcharges under letters A to D and K 1 may not be billed.
Zuschlag K 2 lautet: „Zuschlag zu den Leistungen nach Nummer 45, 46, 48, 50, 51, 55 oder 56 bei Kindern bis zum vollendeten 4. Lebensjahr“ (120 Punkte). — Zuschlag K 2 reads: „Surcharge to the services under Number 45, 46, 48, 50, 51, 55 or 56 for children up to the completed 4th year of life“ (120 points).
„Als Behandlungsfall gilt für die Behandlung derselben Erkrankung der Zeitraum eines Monats nach der jeweils ersten Inanspruchnahme des Arztes.“ — For treatment of the same illness, the treatment case is the period of one month after the patient's first attendance.
„Neben der Leistung nach Nummer 435 sind für die Dauer der stationären intensivmedizinischen Überwachung und Behandlung Leistungen nach den Abschnitten C III und M sowie die Leistungen nach den Nummern 1 bis 56, 61 bis 96, 200 bis 211, 247, 250 bis 268, 270 bis 286a, 288 bis 298, 401 bis 424, 427 bis 433, 483 bis 485, 488 bis 490, 500, 501, 505, 600 bis 609, 634 bis 648, 650 bis 657, 659 bis 661, 665 bis 672, 1529 bis 1532, 1728 bis 1733 und 3055 nicht berechnungsfähig. Diese Leistungen dürfen auch nicht anstelle der Leistung nach Nummer 435 berechnet werden.“ — Alongside the service under Number 435, for the duration of inpatient intensive-care monitoring and treatment, services under Abschnitte C III and M and under Numbers 1 to 56, 61 to 96, 200 to 211, 247, 250 to 268, 270 to 286a, 288 to 298, 401 to 424, 427 to 433, 483 to 485, 488 to 490, 500, 501, 505, 600 to 609, 634 to 648, 650 to 657, 659 to 661, 665 to 672, 1529 to 1532, 1728 to 1733 and 3055 are not billable. Nor may these services be billed instead of the service under Number 435.

The multiplier for Number 55

Number 55 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.

What the service text of Number 55 already names itself — the accompaniment to hospital treatment and, where it takes place, the organisational preparation of the admission — is left out of consideration under § 5 Abs. 2 Satz 3 GOÄ when a fee is assessed. An increase needs a justification that goes beyond these two components already settled in the wording.

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 55

That the hospital treatment was immediately necessary is a condition of the service text itself. Whether that can be traced afterwards depends on whether the connection between the finding and the admission was recorded.

Where organisational preparation of the hospital admission took place, it is part of the service under Number 55. What that preparation consisted of in the particular case is only established later if it was written down.

§ 630f BGB requires the essential measures and their results in immediate temporal connection with the treatment. For an accompaniment that extends over a route from the practice to the hospital, that means the start and end of the accompaniment belong in the record, not only the fact that accompaniment took place.

Frequently asked questions

When does Number 55 apply?

When the treating physician accompanies a patient to hospital treatment that is immediately necessary. The service text includes the organisational preparation of the hospital admission where it takes place.

Alongside which services is Number 55 not billable?

The provision for Number 55 excludes Numbers 56, 60 and 833 alongside it. It is also one of Numbers 45 to 55 and 60, for which the Allgemeine Bestimmung for the surcharges E to K 2 limits how often they may be billed per attendance.

What does Number 55 cost?

500 points times the point value of 5,82873 Cent give 29,14 € at the single rate; 2.3 times that is 67,03 €, and 3.5 times is 102,00 €. Rounding is to the cent, under § 5 Abs. 1 Satz 4 GOÄ.