The current German GOÄ has no dedicated fee item labelled PRP. The most robust starting point is a specific billing guidance case published by the German Medical Association (BÄK), with clear conclusions on item 284, blood collection, centrifugation and intra-articular injection. This guide separates well-supported statements from unresolved billing questions.
The published case concerned three intra-articular treatments for coxarthrosis using a mixture of PRP and hyaluronic acid. The blood was centrifuged in a closed system. A major point of dispute was the additional analogue use of item 792 for centrifugation.
In the conciliation procedure conducted by the competent State Medical Association, GOÄ item 284 was regarded as the original core service including blood collection. In the specific case, the additional time required for processing was reflected by the 3.5 multiplier. Item 255 was additionally accepted because of the more demanding intra-articular hip injection. This assessment was subsequently published in the German Medical Association’s GOÄ guide.
| Item | Assessment in reference case | Multiplier | Amount |
|---|---|---|---|
| 284 | Autologous blood injection including blood collection – accepted; preparation effort reflected by multiplier. | 3,5 | 18,36 € |
| 255 | Intra-articular hip injection – additionally accepted in the specific case. | 2,3 | 12,74 € |
| 250 | Venous blood collection – not additional, because already included in item 284. | — | — |
| 792 A | Centrifugation, analogue – rejected; not an independent analogue service in that case. | — | — |
For an intra-articular PRP procedure that is structurally similar to the BÄK case, item 284 is currently the most strongly supported official starting point. A separately performed intra-articular service may bring item 255 into consideration; if an actual joint puncture is performed, the puncture items and their included services must instead be assessed.
The treatment objective matters. If joint fluid is aspirated or the joint is irrigated, the associated injection cannot simply be duplicated as a separate item 255 without checking the inclusion rules.
The reviewed BÄK sources contain no similarly specific PRP billing guidance for broad facial treatments or numerous intradermal scalp deposits. BÄK guidance for botulinum toxin and hyaluronic acid classifies broad local applications under items 267/268 depending on extent.
That filler framework may inform a billing discussion, but it must not be presented as an official PRP billing recommendation. Charging item 252 for every individual needle puncture is expressly not recommended here as a standard model.
Section 10 GOÄ generally allows reimbursement of certain medicines, dressings and other materials retained by the patient or consumed in a single use. At the same time, the provision expressly excludes certain disposable items and prohibits flat-rate expense charges.
A specialised PRP tube or closed single-use preparation system may therefore potentially qualify as an expense. A complete “PRP kit”, however, is not automatically billable in full; its components must be assessed under § 10.
| Item | Assessment | Reason / note |
|---|---|---|
| Special PRP/PRF tube or closed preparation system | may be billable | Single-use consumption and the absence of an exclusion under § 10 must be checked for the specific product. |
| Disposable syringes, disposable needles, disposable gloves | not billable | Expressly excluded under § 10(2). |
| Centrifuge, rotor, maintenance, calibration | not an expense | Practice/equipment costs; generally covered by the professional fee. |
| Single eligible expense over €25.56 | proof required | A receipt or other evidence must be attached to the invoice. |
Within the ordinary fee range, the multiplier depends on the difficulty, time required and circumstances of the individual service. Exceeding the threshold must be explained in a comprehensible, service-specific way. “Because it is PRP” is not sufficient. In the BÄK case, the additional time for centrifugation supported the 3.5 multiplier for item 284.
If the ordinary GOÄ range does not adequately reflect the intended fee, the answer is not to create an artificial chain of fee items. Where the particular fee item is legally eligible, an individual fee agreement under § 2 GOÄ can be concluded before the service, subject to strict formal requirements.
This table is a calculation and orientation aid, not a recommendation to combine the items. Item 250 is subject to the special reduced range, with a 1.8 threshold and a 2.5 maximum.
| Item | Service, shortened | Points | at threshold | at maximum |
|---|---|---|---|---|
| 1 | Consultation | 80 | 10.72 € | 16.32 € |
| 3 | Detailed consultation, at least 10 minutes | 150 | 20.11 € | 30.60 € |
| 5 | Symptom-related examination | 80 | 10.72 € | 16.32 € |
| 7 | Examination of one organ system | 160 | 21.45 € | 32.64 € |
| 250 | Venous blood collection | 40 | 4.20 € | 5.83 € |
| 252 | Subcutaneous / submucosal / intracutaneous / intramuscular injection | 40 | 5.36 € | 8.16 € |
| 255 | Intra-articular or perineural injection | 95 | 12.74 € | 19.38 € |
| 267 | Medicinal infiltration treatment, one body region | 80 | 10.72 € | 16.32 € |
| 268 | Medicinal infiltration treatment, several body regions | 130 | 17.43 € | 26.52 € |
| 284 | Autologous blood injection including blood collection | 90 | 12.07 € | 18.36 € |
| 302 | Puncture of a shoulder or hip joint | 250 | 33.52 € | 51.00 € |
| 490 | Infiltration anaesthesia of small areas | 61 | 8.18 € | 12.44 € |
| 491 | Infiltration anaesthesia of large areas | 121 | 16.22 € | 24.68 € |
A defensible PRP invoice is not created on the invoice alone. Diagnosis, documented procedure and fee item should tell the same clinical story.
Document findings, indication, consent, blood collection, system used, preparation, exact application site and any relevant special circumstances.
Explain diagnosis, course, relevant previous treatments, treatment objective and the clinical reasoning – especially when an insurer asks questions.
State the service date, item number and description, multiplier, amount, any individual justification and permissible expenses precisely. In particular, § 12(2) GOÄ governs the mandatory invoice information and § 12(3) GOÄ the service-specific justification when the threshold is exceeded.
PRP is not automatically a “requested service” under § 1(2) GOÄ. The decisive question is whether the specific treatment is medically necessary. Purely cosmetic procedures without a disease-related objective are typically requested services and must be identified accordingly.
A GOÄ-compliant invoice is not a reimbursement guarantee. Where full third-party reimbursement is foreseeably uncertain, the patient must be informed in text form of the expected costs before treatment under § 630c(3) BGB.
Federal aid rules list PRP/PRF under modified autologous blood treatment and allow only narrowly defined exceptions: certain dental applications after tooth extraction and, in ophthalmology, autologous serum eye drops made from the patient’s own blood as a tear substitute in the specified sicca/Meibomian-gland situations. The ophthalmic exception is not a PRP treatment but another autologous-blood application within the same aid category. There is no general eligibility for orthopaedic PRP treatment. State-level aid rules must be checked separately.
The abbreviation PRP does not decide the tax treatment; the treatment objective does. Purely cosmetic aesthetic procedures are generally taxable, whereas a properly documented therapeutic treatment may qualify for the medical VAT exemption under the relevant conditions.
PRP, as an autologous blood preparation, is subject to medicinal-product law requirements. For physicians, § 13(2b) AMG provides an exemption from the manufacturing authorisation under the stated conditions when manufacture takes place under the physician’s direct professional responsibility for personal use in a specific patient. The exemption does not apply to ATMPs. Authorisation-exempt manufacture must generally be notified to the competent state authority under § 67(2) AMG.
For GOÄ billing this is only indirectly relevant: documentation, sterile procedures or standard steps that are legally required do not automatically justify a higher multiplier. Only genuinely above-average time, difficulty or special circumstances in the individual case may be considered under § 5(2) GOÄ.
The joint BÄK/PKV draft updated in July 2026 is not current law. Its structure is nevertheless notable for PRP: an autologous blood injection item is followed by a separate surcharge for special technical/apparative preparation.
“Autologous blood injection”, including prior blood collection and, where applicable, preparation of the blood and/or addition of medicines. Proposed fee: €22.21.
Surcharge to item 776 for increased effort involving special technical/apparative preparation. Proposed fee: €11.21.
The former single-item calculator is replaced here by four linked tools. They help check fee items, review expenses under § 10 GOÄ, calculate session economics using your own figures and check an existing fee agreement under § 2 GOÄ against the required elements.
These tools use only the values you enter and reflect the rules of the German GOÄ fee schedule. They do not assess an individual case, recommend a combination of fee items, or replace legal, medical-law or tax advice.
Build the fee items for one session. The calculator totals each line, flags when a written justification under § 12(3) GOÄ is required, and checks the list against selected GOÄ billing rules. Whether an item may be billed in a specific case depends on the service actually provided.
Note: Fee-item names in the dropdown retain the official German GOÄ wording; translations elsewhere are explanatory.
| No. | Service | Points | Factor | Quantity | Amount | Formal consequence | |
|---|---|---|---|---|---|---|---|
| Total physician fee | 0,00 € | ||||||
Select what was actually consumed during the session and enter your actual cost. The classification follows § 10 GOÄ and the BÄK interpretation: paragraph 1 identifies expenses that may qualify, while paragraph 2 lists materials that are not billable. Whether a specific product meets the requirements must be checked in the individual case.
This calculation does not make a billing-law statement. It compares your fee with the time and material costs you enter. Expenses under § 10 GOÄ are passed through at cost and do not generate profit.
This checklist reflects the formal requirements of § 2 GOÄ for a deviating fee agreement. It does not generate a contract and does not replace legal review of your form.