German Dental FHIR Profiles (R4) - Local Development build (v0.41.6) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

GOZ Fee Agreement

GOZ fee agreement under § 2

GozChargeItemDE distinguishes two evidence paths:

1. A medically indicated service with factorOverride > 3.5 requires GozHonorarvereinbarungExt, representing the written fee agreement under GOZ § 2(1)-(2).
2. A requested service without medical necessity uses VerlangensleistungExt and its required written treatment and cost plan under GOZ § 2(3).

The primary source is GOZ § 2.

Structured agreement evidence

GozHonorarvereinbarungExt contains:

• a DocumentReference to the written agreement;
• the agreement date, which must be before occurrenceDateTime;
• the resulting agreed amount in EUR; and
• a fixed reimbursementNoticeGiven = true assertion.

The referenced document remains authoritative for the service number and description, agreed factor, personal discussion, signatures, copy handover, and the reimbursement warning. The IG does not infer those process facts merely because a reference exists.

Factor 3.5 is the boundary and does not trigger the extension. A factor above 3.5 without either the § 2(1)-(2) agreement or the separate requested-service path violates goz-factor-agreement.

Invoice boundary

GOZ § 10 requires invoice details and a service-specific reason above factor 2.3. It does not establish a generic rule that the § 2 agreement must be attached to the invoice, so this IG adds no such invariant.

GozInvoiceDE references GozChargeItemDE from each DiPag line item. A line under § 2(1)-(2) therefore reaches both the structured reimbursement notice and the agreement DocumentReference through GozHonorarvereinbarungExt. The ExampleGozAgreementInvoice example demonstrates this chain without duplicating the agreement on the invoice.

See Billing and Legal Sources for the complete source register and rejected assertions.