Billing skin analysis, which GOÄ code applies when

Digital 3D skin analysis has no dedicated entry in the German GOÄ (fee schedule for physicians). The schedule was last updated in substance before this technology existed. Practices today bill via two paths: either using a related code with an appropriate multiplier, or analogously per § 6 (2) GOÄ. This article walks through both.

Important caveat: this text does not replace advice from your regional medical association or a specialised tax advisor. We describe how dermatology and aesthetic practices currently handle billing in Germany.

The three codes practices use today

Three GOÄ codes are candidates. Each covers a different scope and carries a different point value, the difference adds up quickly, often 40 to 80 euros per patient.

GOÄ 750, Dermatoscopy

The standard code for manual dermatoscopy. 70 points, single rate €4.08. At the 2.3× multiplier you reach €9.38 net. The code is intended for manual dermatoscopy of individual skin lesions, it fits 3D analysis only if you document specific pigment or wrinkle regions separately. For a whole-face scan it is too narrow.

GOÄ A612, Video dermatoscopy

A612 (analogous to 612 skin conductance measurement) is by far the most common code practices use for digital imaging. The German Medical Association explicitly recommends it for digital skin measurement and documentation. 250 points, single rate €14.57. At 2.3×: €33.52. This covers the capture and analysis itself, not patient consultation. Bill the consultation separately via code 1 (basic advice) or 3 (extended advice over 10 minutes).

Analogous billing per § 6 (2) GOÄ

For services missing from the schedule entirely, § 6 (2) permits billing by analogy. You pick a comparable code and prefix the number with A. For an extended 3D capture with multi-spectral imaging, some practices use A4870 (photodynamic therapy as analogue), 1190 points, at a 1.8× multiplier roughly €124. This requires written justification of the extra effort: multi-channel imaging, 3D reconstruction, AI-assisted analysis.

Statutory-insured patients: why analysis becomes a self-pay (IGeL) service

Statutory health insurance does not cover digital skin analysis, it is neither in the EBM catalogue nor in the federal joint committee resolution on skin cancer screening. For these patients the analysis is therefore an individual health service (IGeL).

IGeL requires three formal steps before treatment starts. If even one is missing, the service is deemed improperly arranged, you cannot claim payment. Audits show this is the case in over 30 percent of documented IGeL cases.

1. Written information sheet: what is done, what it costs, medical benefit and limits. Signed by the patient before treatment.
2. Self-pay agreement per § 8 SGB V or § 18 BMV-Ä: patient declares in writing to take the service as a self-payer.
3. Direct GOÄ invoice, not part of the quarterly billing. Patient pays directly.

Private insurance, what to expect on reimbursement

Privately insured patients typically submit the GOÄ invoice to their insurer. Reimbursement depends on the tariff, the multiplier and the documented medical indication. Standard tariffs typically reimburse A612 at 2.3× with a written medical indication; for A4870 analogous or multipliers above 3.5 (which require special justification) the reimbursement rate drops significantly. A blanket reimbursement percentage cannot be quoted seriously because it depends strongly on insurer and tariff.

For that reason we recommend A612 at 2.3× as the robust default, complemented by code 1 (consultation) and code 3 for longer findings discussions.

Common billing mistakes

• Trying to bill skin analysis through EBM, impossible, it is not a statutory benefit. The regional association will reject.
• Multiplier above 2.3 without written justification. Above 2.3 requires justification text on the invoice.
• Bundling consultation and imaging into one code. Both are separate services that must be documented apart.
• Verbal IGeL information. Without signature the fee is not enforceable.
• Multiple sessions on one invoice without date stamps. Each session needs its own date and code.

How this shows up in practice management software

Most German PMS (Medistar, T2med, CGM Albis) ship A612 as standard. The analogous code A4870 typically needs to be entered as a free code. Dermalia does not couple report creation to your PMS, you create the invoice manually because remuneration sits outside our responsibility. A GDT export of the report PDF for the electronic patient record is on the roadmap; remuneration data is never touched.

How Dermalia fits into your remuneration

Dermalia is not a patient-side fee, we bill your practice (per scan or per month, see pricing page). Your GOÄ invoice to the patient runs separately. That keeps your patient invoice independent of our backend pricing and lets you declare the full multiplier as a practice service.