{"id":29321,"date":"2026-10-28T09:11:59","date_gmt":"2026-10-28T09:11:59","guid":{"rendered":"https:\/\/quickbirdmedical.com\/?post_type=news&#038;p=29321"},"modified":"2026-10-28T09:23:03","modified_gmt":"2026-10-28T09:23:03","slug":"diga-pricing-maximum-amounts-threshold-2026","status":"publish","type":"news","link":"https:\/\/quickbirdmedical.com\/en\/news\/diga-pricing-maximum-amounts-threshold-2026\/","title":{"rendered":"New DiGA Maximum Amounts and Threshold since October 1, 2026"},"content":{"rendered":"<p>The GKV-Spitzenverband (National Association of Statutory Health Insurance Funds) has published its regular update of the <strong>maximum amounts and threshold for DiGA through March 31, 2027<\/strong>. Maximum amounts limit reimbursement until the reimbursement amount negotiated with the GKV-Spitzenverband or set by the arbitration board applies. For DiGA pricing, group maximum amounts now exist for only two groups:<\/p>\n<ol>\n<li>Diseases of the urogenital system | medical benefit<\/li>\n<li>Mental disorders | medical benefit<\/li>\n<\/ol>\n<p>A year ago, there were still five groups: A group requires at least two DiGA, each of which counts only during its first 36 months. With few new listings, groups therefore cease to exist. Since July 2026, the legislator has also required a maximum amount for DiGA that are not assigned to any group. The framework agreement has not yet been amended accordingly.<\/p>\n<p>The threshold, which is also published, has a different effect: Price negotiations are waived only as long as a DiGA has continuously stayed below the threshold with its daily price since its listing and at the same time below \u20ac750,000 in GKV revenue on a rolling twelve-month basis. This applies to both provisionally and permanently listed DiGA. Manufacturers must report when they make use of the exemption and when they reach a limit. Manufacturers whose price was just below the old threshold keep the exemption only if they lower the price below the new value without delay. The threshold is a quarter of the average price of all DiGA and has fallen significantly since 2023, in line with market prices, to \u20ac0.84 per calendar day. This corresponds to a DiGA that costs \u20ac75.60 for 90 days.<\/p>\n<p>Historical and current values can be found here: <a href=\"https:\/\/www.gkv-spitzenverband.de\/krankenversicherung\/digitalisierung\/kv_diga\/hoechstbetraege_und_schwellenwerte\/hb_sw.jsp?utm_source=website-quickbirdmedical&amp;utm_medium=website&amp;utm_campaign=news\">Maximum amounts and thresholds at the GKV-Spitzenverband (German)<\/a><\/p>\n<p><a href=\"https:\/\/quickbirdmedical.com\/wp-content\/uploads\/\/2026\/10\/diga-hoechstbetraege-schwellenwert-en.svg\"><img decoding=\"async\" class=\"alignnone wp-image-29638 size-large\" src=\"https:\/\/quickbirdmedical.com\/wp-content\/uploads\/\/2026\/10\/diga-hoechstbetraege-schwellenwert-en.svg\" alt=\"Infographic on DiGA maximum amounts and threshold: 2 groups instead of 5, no price negotiation below \u20ac0.84 per day and \u20ac750,000 in revenue\" width=\"1024\" height=\"579\" \/><\/a><\/p>\n","protected":false},"featured_media":0,"template":"","categories":[],"tags":[],"display":[54],"class_list":["post-29321","news","type-news","status-publish","hentry","display-display-on-news-page"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>DiGA Pricing: New Maximum Amounts and Threshold<\/title>\n<meta name=\"description\" content=\"DiGA pricing since October 1, 2026: Maximum amounts for only two groups and a threshold of \u20ac0.84 per day. 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