Germany overhauls hospital billing with 2026 reimbursement reforms
Germany’s healthcare system is set for major changes in 2026 after key organisations finalised new reimbursement rules. The updated flat-rate payment catalog (aG-DRG) will now cover over 17 million inpatient cases each year. A significant expansion of the Hybrid-DRG system also aims to push more treatments into outpatient care.
The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), the German Hospital Federation (DKG), and the Association of Private Health Insurers (PKV) have agreed on the 2026 aG-DRG catalog. This framework will form the basis for budget talks between hospitals and insurers. For the first time, it includes a detailed breakdown of valuation ratios for standby cost components.
The new rules take effect in 2026 and will apply to all inpatient treatments across Germany. Hospitals and insurers will use the aG-DRG catalog as the legal foundation for billing. Meanwhile, the expanded Hybrid-DRG system is expected to accelerate the shift toward outpatient care, reducing overall system costs.
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