What Does a Private Service Really Cost?

Many practice owners still calculate their private services by gut feeling. Or they adopt prices from colleagues – without knowing whether it makes economic sense.

👉 Yet the solution is simple – and important for sustainable practice success.

We at NuklearPlan have developed a tool that calculates private services in an economically sensible way: ✔ Materials ✔ Staff ✔ Equipment ✔ Room costs ✔ realistic profit margin

✅ What is Permitted – and Under Which Conditions?

1. Private Services Must Be Medically Justifiable

• The service must not be covered by statutory health insurance.
• It must not cause medical harm or be ethically questionable.
• It must correspond to the current state of medical science (→ Evidence-based Medicine).

🔹 Permitted Example: Vitamin D determination at patient’s request without clinical indication. 🔹 Critical Example: PSA test without explanation of benefits and risks (Federal Court ruling 2012).

🚫 What is Prohibited or Critical?

2. Prohibited Private Services (according to medical professional codes)

• Services that are medically not indicated but sold with fear or pressure.
• Coercive offers: e.g., “If you don’t do this, we won’t accept you as a patient”.
• Services that violate medical independence or advertising regulations.
• Services to statutory patients that would actually be covered services – billing as private → billing fraud

📋 Formal Requirements

3. Information & Consent

• Before every private service, written information must be provided:
  • What is the benefit?
  • Are there alternatives?
  • What costs arise?
• The patient must voluntarily consent – before beginning treatment.
• Consent should be documented and signed.

➡️ Medical associations recommend standardised private service forms for this.

Billing & Accounting

• Billing follows the official fee schedule for physicians.
• You may only use codes that factually fit.
• A transparent invoice must be created and given to the patient.
• No surcharge for “private service” allowed – only regulation-compliant billing with possible scaling factors.

📚 Legal Sources & Recommendations

• Healthcare Structure Act
• Professional codes of regional medical associations
• Medical associations: monitoring websites
• Court rulings on information obligations for private services