ENThe price of a course of radiation treatment in Germany has no single figure: radiotherapy runs over weeks rather than being one procedure, and the bill covers simulation, planning, sessions and technique. Even for one diagnosis, one standard schedule can be almost half as long as another.
Below: what the estimate contains, what moves the total, what it omits and how to get a written calculation. No averages appear, since they help nobody budget. For the method itself, see radiation therapy in Germany.
What the bill is made of
Radiotherapy cost in Germany is built from the stages of a course, each with its own bill line: the radiation oncologist’s consultation; a planning CT in the treatment position, sometimes with MRI or PET for image fusion; a custom mask or cushions; physics planning of fields and dose; sessions on a linear accelerator; verification images; reviews by the doctor, often weekly; and a closing appointment.
The total grows fastest with session count and planning complexity: each session is billed, the plan once per course. IMRT and VMAT (intensity-modulated beams) and stereotactic treatment need longer preparation and exact physics, so they are billed differently from simple three-field treatment. GOÄ has no dedicated items for them; for IMRT the German Medical Association recommends No. 5855 per session, planning included.
Outpatient treatment is usually billed under GOÄ, the official fee schedule for doctors, a hospital stay through the DRG system as one sum per case, so centre and hospital bills differ. GOÄ items carry points worth 5.82873 cents each, times a factor: for radiotherapy normally up to 1.8, higher only with a written reason, at most 2.5; no other fee may be agreed (§ 2 and § 5 GOÄ). Inpatient GOÄ fees are cut by 25% (§ 6a).
| Cost item | What it depends on | Guide figure |
|---|---|---|
| Consultations, reviews, verification images | number of visits | per clinic estimate |
| Planning CT, MRI or PET | body region, contrast | per clinic estimate |
| Mask and cushions | custom-made or not | per clinic estimate |
| Treatment plan | once per course | No. 5831: €157.38 at 1.8, surcharges No. 5832 and 5833: €29.14 and €116.57 at the single rate; total per estimate |
| Session on the accelerator | sessions; over two fields adds No. 5837 | No. 5836: €104.92 at 1.8; total per estimate |
| Hospital stay | admission needed or not | DRG, per clinic estimate |
What changes the total most
The number of sessions changes the total most. Conventional courses give small doses over many weeks, hypofractionated ones more per session, stereotactic ones a few sessions. For prostate cancer, conventional treatment takes about 7 to 9 weeks, a shortened course, say, 20 sessions over 4 weeks. The choice follows diagnosis and aim, not budget, and shorter is not automatically cheaper: each session is more demanding.
Technique comes second: a standard linear accelerator, stereotactic treatment of single deposits, or brachytherapy, with the source brought to the tumour from inside and its own GOÄ items. Proton and ion therapy have a separate price bracket: see proton therapy in Germany and proton therapy cost in Germany.
Third, the patient: a hospital stay or outpatient treatment, chemotherapy alongside, anaesthesia (for children, say), extra imaging before planning. Concurrent treatment is usually billed separately.
What an estimate leaves out
An estimate usually leaves out what surrounds treatment: initial diagnostics and any histology review; accommodation for the whole course, as sessions usually run every weekday; interpreting; travel and visa; supportive medication and side-effect treatment; follow-up imaging. More: cancer treatment prices in Germany.
A proper written estimate states the number of sessions, the technique, what a session includes, what is extra, how long it is valid and what happens if the course changes. GOÄ requires the planning invoice to give the planned number of sessions and allows re-billing the plan only after a substantial change. Without a session count, a document is an indication, not an estimate.
Where treatment happens: outpatient centre or hospital
An outpatient centre suits patients having only radiotherapy and staying nearby; a hospital department suits parallel chemotherapy, inpatient monitoring or techniques the centre lacks. Examples, not a ranking: the radiotherapy practice in Munich’s Pasing district, run by Dr Peter Stoll, is outpatient; the Department of Radiotherapy at Augsburg University Hospital, headed by Professor Georg Stüben, is hospital-based. The Heidelberg Ion-Beam Therapy Center (HIT), whose medical lead is PD Dr Semi Harrabi, uses protons and ions.
Compare whole courses at the same session count and technique, not the price per session: a cheap session repeated twice as often costs more.
How to get a calculation for your own case
To get a figure, send discharge letters, histology, CT, MRI or PET discs, any tumour board report and a record of earlier treatment: surgery, chemotherapy and above all previous irradiation of the same area, as re-treatment is planned differently.
The department reviews the records, says whether it takes the case and sends a calculation; the plan is final only after the face-to-face appointment and planning CT, on dates it sets. If the tumour board changes the schedule, the figure changes. The Krebsinformationsdienst of the German Cancer Research Center explains how treatment runs.
Frequently asked questions
How much does one radiotherapy session cost?
The doctor’s item for a session on an accelerator with up to two fields, No. 5836, is €104.92 at a factor of 1.8, at most €145.72 at 2.5; more fields add No. 5837. Compare whole courses, though: IMRT is billed differently.
Can the doctor’s fee be negotiated?
No. For radiotherapy the law forbids agreeing a different fee (§ 2 GOÄ). The factor runs from 1.0 to 2.5, above 1.8 only with a written reason (§ 12 GOÄ); surcharges for CT-based planning and computer dose calculation count at the single rate only.
Is chemotherapy included in the radiotherapy bill?
Usually not: concurrent chemotherapy, supportive medication and side-effect treatment are billed separately. If chemotherapy needs a hospital stay, the hospital bills through the DRG system, one sum per case, not by doctors’ items. Ask for radiotherapy and drug treatment as separate lines.
How AlenMed organises treatment
AlenMed translates the records, sends them to two or three departments and translates their calculations line by line, so like is compared with like, and prepares the medical visa paperwork.
AlenMed has 86 partner hospitals in 38 cities, 345 doctors and an office in Munich. A coordinator books appointments, interprets, helps with accommodation near the centre and collects the discharge letter with the follow-up plan.
This material is for information only and is not an offer; the clinic sets price and treatment after a face-to-face examination.