Availability allowance criteria: how many does your practice meet, and what is it worth?
Calculate your availability allowance (Vorhaltepauschale) under uniform value scale (EBM) no. 03040 in 2 minutes, including case-count adjustment, surcharges and vaccination penalty.
Free · GDPR-compliant · Result in 2 minutes
What the criteria check gives you
Points & euros per case
The calculator breaks down base value, case-count adjustment, vaccination deduction and surcharge level one by one. So you can see exactly how your availability allowance comes about.
Current from Q1/2026
It is based on the resolution of the Valuation Committee (Bewertungsausschuss) on fee schedule item (GOP) 03040. The calculator reflects the current rules instead of working with rough rules of thumb.
Projection
You get your availability allowance projected per quarter and per year. That lets you put the effect on your practice in concrete terms.
How to calculate your availability allowance
Enter practice data
Choose the quarter, enter the number of cases and the number of GPs, and then how often you billed the services of the eight criteria. Each field comes with guidance on what to enter.
Contact details
Leave your contact details to unlock the projection. Details from another MediPulse tool are already filled in.
Get your result
You see points, euros per case and the projection for the quarter and the year. The analysis is available on screen and as a PDF.
The GP availability allowance from 2026, clearly explained
With the availability allowance (Vorhaltepauschale), part of GP remuneration changes. Instead of weighting individual visits more heavily, it rewards the practice for being continuously available. Here is what that means in practice and how the amount is made up.
What the availability allowance is
From 2026, fee schedule item (GOP) 03040 remunerates basic GP care. Instead of paying for individual services, it rewards a practice for being continuously available to its patients. It is billed per treatment case and requires an insured-person flat fee (Versichertenpauschale). This makes it a structure-based flat fee.
How the amount is made up
The starting point is a base value in points per case. This is adjusted to the number of treatment cases per physician. Two deductions can apply to it: 40 percent for fewer than ten vaccinations in the quarter, and 50 percent if 03030 is billed in the same treatment case. Separately, a level I or level II surcharge is added if the respective criteria are met; the deductions do not reduce it. Finally, the points are converted into euros using the orientation value.
What the surcharge levels mean
Eight of the ten criteria require a minimum share of certain fee schedule items across all treatment cases, including vaccinations under Annex 1 of the Vaccination Directive (Schutzimpfungsrichtlinie). The other two concern the practice type, including quality circles, and the consultation hours offered. Which level applies depends on the criteria met. The calculator takes your entries into account and shows which surcharge results.
When it applies
The availability allowance has applied since quarter I/2026. For planning, it is worth knowing the effect for the current quarter, because the structure of remuneration has shifted with it.
What practices can do now
It makes sense to check your own case count and the criteria you meet and to project the expected amount. That shows how the rule affects your quarterly and annual results.
Frequently asked questions
What is the availability allowance (Vorhaltepauschale)?
From 2026, the availability allowance (fee schedule item, GOP, 03040) remunerates maintaining the structures needed for basic GP care. To do this, the resolution redefines the previous additional flat fee to the insured-person flat fees 03000 and 03030 and adds two tiered surcharges.
How much is the availability allowance for GPs in 2026?
It is tiered by cases per physician: below 400 cases about €14.65 per case, in between €16.31, above 1,200 cases about €17.45. From 2027 the orientation value rises to 13.0207 cents, giving about €14.97, €16.67 and €17.84. The two deductions have a greater effect than this tiering. These are values calculated on the nationwide orientation value; the regionally applicable point value may differ. If the criteria are met, 10 points (GOP 03041) or 30 points (GOP 03042) are added; the two surcharges are mutually exclusive.
How does the case-count adjustment work?
The base is 128 points per case. Practices with more than 1,200 treatment cases per physician and quarter receive a surcharge of 9 points, practices with fewer than 400 cases per physician a deduction of 13 points. The number of physicians is based on the scope of activity stated in the admission or approval notice, not on headcount.
How does the number of vaccinations matter?
In two places. Practices that provide fewer than 10 services under Annex 1 of the Vaccination Directive in a quarter receive a 40 percent deduction on GOP 03040; diabetology, HIV and substitution specialty practices are exempt. Independently of that, a vaccination share of 7 percent, 25 percent in the fourth quarter, is one of the ten criteria for the surcharges. The calculator takes both into account.
Does the availability allowance also apply under GP-centered care (HZV)?
No. The availability allowance is an EBM service; GP-centered care (HZV) has its own contractual rules. According to KV Nordrhein, the statutory health insurance association (KV) for the North Rhine region, HZV cases also do not count toward the criteria. So enter only your KV cases, without HZV and without emergency service.
What applies to patients with a care flat fee (Versorgungspauschale)?
Since July 1, 2026, the KV applies 03043 instead of 03040 for patients with a care flat fee (EBM no. 03100): 179 points, plus 14 points for two to seven and 42 points for eight or more criteria met. With fewer than 400 cases per physician, 18 points are deducted; with more than 1,200, 13 are added. Criteria and vaccination deduction apply as for 03040. If you enter the number of these patients, the calculator calculates both flat fees separately (resolution of the Valuation Committee, 828th meeting).
When does the new rule apply?
The rule applies from quarter I/2026. The calculator reflects the adopted status so you can assess the effect on your practice.
Is the calculator free?
Yes, the calculator is free and non-binding. You don't need a subscription, only valid contact details to unlock it.
What happens to my data?
Your data is processed in compliance with the GDPR and used solely to get in touch with you. It is not passed on to third parties.
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