Billing as a doctor or alternative practitioner! How do I bill for aesthetic services?

Billing aesthetic services correctly:
A guide for physicians and alternative practitioners considering materials, VAT and GOÄ

Aesthetic services are becoming increasingly important in medical and alternative practices. Patients not only want medical treatments, but also aesthetic improvements that increase their well-being and self-confidence. As a doctor or alternative practitioner, it is important to bill these aesthetic services correctly in order to take legal, financial and tax aspects into account. In this blog article, we will take a closer look at the billing of aesthetic services, taking into account materials, VAT and the German Medical Fee Schedule (GOÄ).

Selection of materials:

When billing for aesthetic services, the choice of materials used is of great importance. Depending on the type of treatment, different materials such as implants, fillers or medication may be required.
It is important to take appropriate account of the costs of these materials and to record them correctly in the invoice. Record all relevant information about the materials used in the patient file to ensure transparent billing. As a doctor in particular, you should not charge any mark-ups on the actual purchase prices in order to avoid accusations of commercial activity and the associated trade tax from the outset.

Consideration of value added tax:

Value added tax (VAT) plays a role in the billing of aesthetic services. In some exceptional cases, aesthetic procedures can be classified as medically necessary and are therefore exempt from VAT. This can vary depending on the country and the tax regulations applicable there. In principle, however, purely aesthetic services are subject to VAT!

Find out about the specific regulations in your country and, if necessary, consult a tax advisor to ensure that you account for VAT correctly.

The scale of fees for doctors (GOÄ):

The GOÄ is the definitive billing basis for medical services in Germany. It regulates the fees for medical services, including aesthetic procedures.
Doctors should familiarize themselves with the relevant fee items in order to code the services provided correctly and bill them appropriately.

The GOÄ provides detailed information on the individual items, their valuation and the billing method.
It should be borne in mind that there can never be fixed prices for aesthetic medical services! The prices must always be calculated individually according to the respective fee code and the resulting rate of increase. This depends, among other things, on the time, manual and intellectual effort involved.
An increment rate of 1.0 to 2.3 is the norm. Higher rates of increase up to 3.5 require justification. Higher rates must be agreed in advance with the patient in the form of a fee agreement.
The GOÄ does not provide for completely free medical services, such as free initial consultations, and is therefore not permitted.

However, please note that the GOÄ does not apply to alternative practitioners, as it is only binding for doctors.
You can also find specific billing examples for aesthetic treatments with specific GOÄ figures and explanations in our Hyaluronic acid basic courseand our Muscle relaxants basic course.

Transparent information and billing:

Transparency in communication with your patients is crucial, especially when it comes to aesthetic services. Explain to your patient in advance the costs of the treatment that will be charged. Provide clear information about the material costs involved, any additional services and the expected total amount. Make sure your patients understand all the information and give written consent before starting treatment.

Conclusion:

The correct billing of esthetic services requires a thorough understanding of material costs, VAT regulations and the relevant billing principles, such as the GOÄ.

By taking these aspects into account and maintaining transparent communication with patients, doctors and alternative practitioners can ensure smooth billing and strengthen patient confidence. If there are any uncertainties or questions, it is advisable to contact specialized consultants or associations in order to obtain precise information and comply with legal regulations. We also cover the topic of billing in our basic courses.