German scale of fees for dentists

What does the GOZ govern?

It contains a fee schedule in which every dental service has a number and a point value. The fee is calculated as point value multiplied by point price multiplied by the scaling factor. The point price is 5.62421 euro cents. For services not listed in the schedule, § 6 GOZ permits billing according to an equivalent listed item. Medically necessary medical services such as certain radiographs are billed under the scale of fees for physicians. Material and laboratory costs are charged separately and must be itemised. Before more extensive treatment, the patient receives a written cost estimate.

How does the scaling factor work?

Under § 5 GOZ the range runs from the single rate to 3.5 times the base rate. Up to 2.3 times the base rate, no special justification is required; this value is treated as the standard rate for an averagely demanding service. Above that, a written justification specific to the individual case is required. A rate higher than 3.5 times the base rate is only possible through a separate agreement under § 2 GOZ, which must be concluded in writing before treatment begins. Private insurers often reimburse only up to a certain factor, with the difference borne by the patient. The appropriateness of justifications is therefore regularly disputed, and the chambers maintain fee advisory services and a case law database on this.

Where is the weak point?

The point price has been unchanged since 1988, while practice and material costs have risen considerably. The German Dental Association most recently called on 30 May 2025 for an independent revision of the GOZ, separate from the revision of the scale of fees for physicians. A new version has not yet come into force. Anyone relying on announced reforms is planning on uncertain ground. In practice this means: the scaling factor is currently the only instrument for reflecting rising costs, and it must remain justifiable on the facts of each case.

What does this mean for graduates returning from EU countries?

Private billing is practically unheard of in degree programmes in Bulgaria, Romania, Hungary, or Croatia. After receiving a dental licence, however, it is everyday practice, particularly in implantology and high-quality dental prosthetics. Billing seminars are offered by the state dental chambers; the equivalent in the statutory insurance sector is the BEMA.