Lung cancer is the leading cause of cancer death in Germany. The Federal Joint Committee (G-BA), with the affirmative vote of KBV, resolved to include LDCT-based lung cancer early detection for high-risk smokers as a statutory insurance benefit. This makes Germany the first major European economy to establish a fully reimbursed national lung screening program with dedicated EBM billing codes — a milestone that will shape LDCT screening reimbursement across Europe.
The legal basis rests on Section D, Part III of the G-BA Cancer Screening Directive (Krebsfrüherkennungs-Richtlinie) and the Lung Cancer Early Detection Ordinance (Lungenkrebs-Früherkennungs-Verordnung), enacted in 2024.
Two things stand out about this decision:
1. Reimbursement is confirmed — and extrabudgetary. Eight new billing codes (GOP 01871–01881) go live on April 1, 2026, covering the full screening workflow from initial counseling through LDCT acquisition, primary and consultative second reading, patient counseling for findings requiring workup, and multidisciplinary consensus conferences. Critically, these are reimbursed outside the morbidity-based total remuneration cap (extrabudgetäre Vergütung) — meaning they come from a separate funding pool and do not erode existing outpatient budgets.
2. AI-assisted detection is mandatory, not optional. The Lung Cancer Early Detection Ordinance (LuKrFrühErkV) requires that LDCT images be interpreted with the support of qualified computer-assisted detection (CAD) software. This is not a recommendation — it is a regulatory requirement built into the screening workflow from day one.
The eight new billing codes define a specific clinical pathway with built-in quality controls:
• Primary care (general practice / internal medicine) handles eligibility assessment, initial counseling, and report preparation. Two billing codes cover this gatekeeping function.
• Radiology carries the diagnostic workload. Six billing codes cover initial LDCT examination, follow-up LDCT (within 12 months for findings requiring monitoring), referral for second reading, consultative second reading by an independent specialist, patient counseling for findings requiring further workup, and participation in multidisciplinary consensus conferences.
The structure encodes a mandatory dual-reading model: when findings are suspicious or require further evaluation, an independent second reader — based at a certified lung cancer center — must be consulted. Both readers then reach a consensus recommendation together.
Not every physician can bill every code.
General practitioners and internists may only bill the counseling and report codes. The remaining six codes are exclusively reserved for radiologists who meet specific qualification requirements: specialized training in lung cancer screening, a minimum volume threshold of thorax CTs, and KV-level authorization for radiation diagnostics.
The mandatory use of CAD software applies to all radiologists performing LDCT screening — both primary and second readers.
For radiology practices and hospital imaging departments, this reimbursement framework creates a clear economic case for participation — with extrabudgetary funding meaning genuinely incremental revenue, not a redistribution of existing budgets.
However, participation demands more than imaging capacity. The billing codes encode a specific quality architecture: mandatory dual reading with CAD software support, structured reporting, consensus conferences, and longitudinal patient tracking. For radiology groups operating across multiple sites, ensuring consistency in nodule detection, measurement, and follow-up protocols becomes the core operational challenge — one that reimbursement alone does not solve.
This is where the intersection of policy and technology becomes critical.
Active and former heavy smokers aged 50–75 who have smoked for at least 25 years with a minimum of 15 pack-years. Eligibility is assessed by a general practitioner or internist, who then refers qualifying patients to a certified radiologist. The specific criteria are defined in Section D, Part III of the G-BA Cancer Screening Directive.
The Lung Cancer Early Detection Ordinance (LuKrFrühErkV) requires all LDCT images to be interpreted with the support of qualified computer-assisted detection (CAD) software. At national scale, the program must ensure consistent nodule detection and measurement across hundreds of sites and readers. AI standardizes this process and reduces inter-reader variability — which is why Germany built it into the regulatory framework from day one, not as a recommendation but as a requirement.
Radiologists must complete specialized training in lung cancer screening, have performed a minimum number of thorax CTs in the preceding year, and hold KV-level authorization for radiation diagnostics. In the first screening year, they must perform at least 100 LDCT examinations, rising to 200 in the second year. Both primary and second readers must use CAD software and hold a KV-issued participation approval.
It means these screening services are paid from a separate funding pool, outside the morbidity-based total remuneration cap (morbiditätsbedingte Gesamtvergütung) that governs most outpatient services. For participating practices, this represents genuinely additional revenue — not a redistribution of existing budgets.
As national lung screening programs scale, reimbursement alone is not sufficient. What ultimately determines whether a program succeeds at population level is the ability to maintain consistent detection quality, structured reporting, and longitudinal tracking across diverse clinical sites. Germany recognized this when the Lung Cancer Early Detection Ordinance (LuKrFrühErkV) made AI-based computer-assisted detection software a mandatory component — because at scale, human-only workflows cannot guarantee the consistency that a national program demands.
Coreline Soft has been building toward this moment since before Germany's reimbursement framework existed. In 2022, the company was selected as the sole AI software supplier for HANSE (Holistic Implementation Study Assessing a Northern German Interdisciplinary Lung Cancer Screening Effort) STUDY, Germany's government-led national lung cancer screening pilot program in northern Germany. Through HANSE, Coreline Soft played a pivotal role in validating that AI-powered LDCT screening workflows could meet the quality thresholds a national program requires. The solution deployed — AVIEW LCS Plus — is an AI platform specialized in automated pulmonary nodule detection and analysis on low-dose CT, holding FDA clearance, CE marking, and full HIPAA/GDPR compliance.
The clinical credibility and operational track record built through the HANSE project has since expanded across Germany. Coreline Soft currently supplies its solution to over 60% of Germany's top 10 hospitals, including institutions referenced in this analysis: the company has supplied AVIEW LCS Plus to Klinikum Chemnitz, a public hospital in Saxony. Beyond Germany, Coreline Soft's footprint extends to Italy's national lung cancer screening project (RISP), the EU-funded six-country 4-IN THE LUNG RUN trial, and a partnership with Bayer's Calantic Medical Imaging AI platform — solidifying its position as a leading AI provider in the European lung cancer screening market.
As Germany's national lung cancer screening program transitions to full statutory insurance coverage in April 2026, the convergence of policy and technology makes Coreline Soft's proven experience more relevant than ever.
In this context, AI is no longer an optional add-on — it becomes part of the infrastructure required to operate national-scale screening programs.
Learn more about Coreline Soft's AI lung cancer screening solution [Click]
• Sources: KVBW (Association of Statutory Health Insurance Physicians, Baden-Württemberg) official announcement (March 13, 2026); Saxony reimbursement analysis report (as of March 13, 2026); KBV 2026 Orientierungswert: 12.7404 cents.
Euro amounts in this article are calculated from officially published EBM point values and the 2026 national orientation value. Actual reimbursement may vary based on each KV region's final published fee schedule.
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