Service text
„Konsiliarische Erörterung zwischen zwei oder mehr liquidationsberechtigten Ärzten, für jeden Arzt“Not alongside — per the Gebührenverzeichnis (4)
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 60 is the consultative discussion between two or more physicians entitled to bill privately, billed for each participating physician individually, valued at 120 points. That gives 6,99 € at the single rate and 16,09 € at the 2.3-fold rate. It is billable only where the physician issuing the invoice has previously, or in immediate temporal connection with the discussion, personally attended to the patient and the patient's illness — and not where the physicians involved belong to the same department or joint practice, or where the discussion is a routine meeting.
The service text of Number 60
Two or more physicians, each entitled to bill privately in their own right, discuss a patient and the patient's illness — that is what Number 60 covers. Whoever bills the number must, under the provisions, have personally attended to the patient and the patient's illness beforehand or in immediate temporal connection with the discussion.
The phrase „für jeden Arzt“ separates Number 60 from fees that arise only once per treatment case: every physician taking part in the discussion may bill it in their own right, provided the provisions are met in their own case.
Excluded is a discussion within the same unit: members of the same hospital department, the same joint practice, or a practice association of physicians of the same or a similar specialty may not bill Number 60 among themselves, and a routine meeting does not fall under it either.
The sentences below stand exactly like this in the Gebührenverzeichnis, as Allgemeine Bestimmungen directly under Number 60. 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.
- „Die Leistung nach Nummer 60 darf nur berechnet werden, wenn sich der liquidierende Arzt zuvor oder in unmittelbarem zeitlichen Zusammenhang mit der konsiliarischen Erörterung persönlich mit dem Patienten und dessen Erkrankung befaßt hat.“ — The service under Number 60 may be billed only if the physician issuing the invoice has, previously or in immediate temporal connection with the consultative discussion, personally attended to the patient and the patient's illness.
- „Die Leistung nach Nummer 60 darf auch dann berechnet werden, wenn die Erörterung zwischen einem liquidationsberechtigten Arzt und dem ständigen persönlichen ärztlichen Vertreter eines anderen liquidationsberechtigten Arztes erfolgt.“ — The service under Number 60 may also be billed where the discussion takes place between a physician entitled to bill privately and the permanent personal medical representative of another physician entitled to bill privately.
- „Die Leistung nach Nummer 60 ist nicht berechnungsfähig, wenn die Ärzte Mitglieder derselben Krankenhausabteilung oder derselben Gemeinschaftspraxis oder einer Praxisgemeinschaft von Ärzten gleicher oder ähnlicher Fachrichtung (z.B. praktischer Arzt und Allgemeinarzt, Internist und praktischer Arzt) sind. Sie ist nicht berechnungsfähig für routinemäßige Besprechungen (z.B. Röntgenbesprechung, Klinik- oder Abteilungskonferenz, Team- oder Mitarbeiterbesprechung, Patientenübergabe).“ — The service under Number 60 is not billable if the physicians are members of the same hospital department, the same Gemeinschaftspraxis (joint practice), or a Praxisgemeinschaft (practice association) of physicians of the same or a similar specialty (e.g. general practitioner and family doctor, internist and general practitioner). It is not billable for routine meetings (e.g. radiology review, clinic or department conference, team or staff meeting, patient handover).
- „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 may not be billed.
- „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 may be billed only at the single fee rate. By way of exception, the surcharges under letters E to H may be billed alongside the service under Number 51 only at half the fee rate. In connection with services under Numbers 45 to 55 and 60, the surcharges may be billed only once per attendance by 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 by the physician, regardless of the number and combination of services performed. The surcharges under letters A to D and K 1 may not be billed alongside the surcharges under letters E to J and K 2.
- „Teilleistungen sind auch dann mit der Gebühr abgegolten, wenn sie von verschiedenen Ärzten erbracht werden. Die Leistung nach Nummer 60 kann nur von dem Arzt berechnet werden, der die Leistung nach Nummer 435 nicht berechnet.“ — Partial services are covered by the fee even where they are performed by different physicians. The service under Number 60 can be billed only by the physician who does not bill the service under Number 435.
- „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.
The multiplier for Number 60
Number 60 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.
Above the 2.3-fold rate, § 12 Abs. 3 GOÄ requires a written justification tied to the particular service, comprehensible and traceable for the person liable to pay. Because Number 60 is billed separately by each physician, such a justification also has to state what, specifically for that physician and that discussion, made up the difficulty or the time taken — not merely that a consultation took place.
§ 5 Abs. 2 GOÄ names the criteria that fee is measured against: the difficulty and the time taken for the particular service, and the circumstances of how it was performed. Criteria already accounted for in the service description are left out of consideration.
What the record has to carry for Number 60
The treatment record is independent of the fee schedule — § 630f BGB requires it in immediate temporal connection with the treatment, whether billed privately or through statutory insurance. For Number 60, that concerns not only the patient but also the fact of the discussion itself: that it took place, and with what content.
Whether the physician issuing the invoice has, previously or in immediate temporal connection with the discussion, personally attended to the patient and the patient's illness can, if disputed, only be shown from the record. The provision makes that personal attention a precondition of billability, not a mere formality.
A written justification under § 12 Abs. 3 can only come from the treatment record, or from nothing. A consultation recorded while the conversation between the physicians takes place supplies exactly the content that could later carry such a justification.
Frequently asked questions
Can every participating physician bill Number 60?
Yes, the service text expressly names „für jeden Arzt“ — every physician entitled to bill privately who takes part in the discussion bills it for themselves.
Is Number 60 billable within the same practice?
No. It is not billable where the physicians are members of the same hospital department, the same joint practice, or a practice association of physicians of the same or a similar specialty, and not for routine meetings either.
What does Number 60 cost at the 2.3-fold rate?
120 points times the point value of 5,82873 Cent give 6,99 € at the single rate; 2.3 times that is 16,09 €, and 3.5 times is 24,48 €. Rounding is to the cent, under § 5 Abs. 1 Satz 4 GOÄ.