GKV savings act 2027: what it means for your practice figures. With worked calculation, examples and checklist.

When does the GKV savings act apply?

The GKV Contribution Rate Stabilization Act (GKV-Beitragssatzstabilisierungsgesetz), usually called the GKV savings act (GKV-Spargesetz), has been in force since July 30, 2026 (act of July 24, 2026, Federal Law Gazette BGBl. I 2026 No. 228). Most of the payment rules for medical practices apply from January 1, 2027.

On October 15, 2026, the Bundestag passed amendments, among other things for outpatient surgery and the volume discount for GPs and pediatricians. The Bundesrat is expected to deal with them on November 20, 2026; until promulgation, these amendments are not in force. The Valuation Committee's (Bewertungsausschuss) requirements for fee distribution will follow by February 15, 2027.

What does the GKV savings act change for medical practices?

The GKV savings act affects fees in four ways: some payments are dropped outright, services previously paid outside the budget move into the budget, some areas stay outside, and the price per point rises only to a limited extent.

• Dropped: supplements and separate payment for referred cases, initial filling of the electronic patient record (ePA), organ donation counseling, hygiene supplements on the flat-rate fees, supplements in the first block of short-term therapy.
• Moves into the budget: services previously paid outside the budget, such as early detection screenings; payment follows your KV's fee distribution.
• Stays outside: outpatient surgery, parts of psychotherapy, the removal of the budget cap for GPs and pediatricians (as of the Bundestag resolution of October 15, 2026).
• Price per point: The orientation value rises by 2.2 percent to 13.0207 cents in 2027 (Valuation Committee, September 23, 2026).

Which services stop being paid in 2027?

From January 1, 2027, payment for these fee schedule items (GOP), among others, is dropped. The associated obligations, such as arranging appointments and counseling on organ donation, remain.

Source: uniform value scale (EBM), as of Q4 2026; National Association of Statutory Health Insurance Physicians (KBV); resolution of the Extended Valuation Committee. Euros at the 2027 orientation value of 13.0207 cents. The full list of all 53 dropped items is in the article GKV-Spargesetz: 53 Gebührenordnungspositionen fallen weg (in German).

What does the GKV savings act mean for GPs?

For GP practices, the main items dropped are the initial filling of the ePA, arranging urgent specialist appointments (03008), organ donation counseling and the hygiene supplement. The removal of the budget cap for GPs remains; the Bundestag deleted the volume discount for additional cases on October 15, 2026.

KV Baden-Württemberg puts the fixed items for GPs at 1.9 percent of 2025 fees (as of September 25, 2026). In the white paper's model calculation, the net practice income of a GP practice falls by 5 to 8 percent, because costs rise faster than the price per point.

What does the GKV savings act mean for specialists?

For specialists, the end of payment for cases referred by the appointment service center (Terminservicestelle) and from open consultation hours is the largest item. KV Baden-Württemberg expects 11.7 percent of fees in ENT and 5.4 percent in orthopedics (fixed items, as of September 25, 2026).

Under the resolution of October 15, outpatient surgery stays outside the budget. From April 1, 2027, a mandatory second opinion applies to certain procedures; the valuation of the technical component in radiology, nuclear medicine and radiation therapy, as well as of cataract surgery, will be reviewed by March 31, 2027.

What does the GKV savings act mean for psychotherapy?

In psychotherapy, the supplements in the first block of short-term therapy are dropped. Parts stay outside the budget: psychotherapy for children and adolescents, complex care for people with severe mental illness, and acute treatment after referral by the appointment service center up to 600 minutes in twelve months (Bundestag resolution of October 15, 2026).

Ongoing approved treatments that are not completed on December 31, 2026, may not be limited by the 2027 fee distribution. The rest of psychotherapy goes into the total remuneration.

How much does the GKV savings act cost a practice?

That depends on the practice. In Baden-Württemberg, the fixed items cost the specialty groups between 0.5 and 11.7 percent of their fees, 2.3 percent on average. On the surplus, the effect is a multiple of that, because salaries, rent and leasing keep running.

Three values are decisive: your share of referred cases and of services previously paid outside the budget, the statutory health insurance share of your revenue, and your KV's fee distribution. The white paper shows the five-step calculation and works through one GP practice and one specialist practice. Download the white paper for free (in German)

Does the point value fall because of the GKV savings act?

No. The orientation value rises by 2.2 percent to 13.0207 cents in 2027. The act limits the increase for 2027 to 2029; the cap for 2027 was 3.42 percent. What can fall is the volume paid out and the payout rate for budgeted services.

At the same time, costs are rising faster: staff expenses per practice owner rose by an average of 8.1 percent per year from 2020 to 2023 (Zi-Praxis-Panel). The staff cost ratio calculator shows where your staff costs stand; the comparison of EBM billing codes by specialty shows which codes your specialty bills and you are missing.