How GOT-Abrechnung Works for German Veterinary Practices
Anyone who runs or works at a veterinary practice in Germany bills for their services according to the Gebührenordnung für Tierärzte, commonly known as the GOT. Many practices have the same questions about it. Is it mandatory to follow it? How much leeway is there in pricing? And what must be included on the invoice for it to be valid? This page explains how GOT billing works in practice, from the structure of the fee schedule to the procedures that ensure no service provided is overlooked when the invoice is prepared.
What GOT Is and Who It Covers
GOT is a regulation that governs what German veterinarians may charge for their services. It provides a list of veterinary procedures with a base fee for each procedure, and it specifies how that fee may be adjusted depending on the circumstances surrounding the treatment.
For individual veterinary practices, this means that the price list is not arbitrary. Every procedure performed on an animal has a corresponding entry in the fee schedule, and the invoice must be traceable to those entries.
Are veterinarians required to bill according to GOT?
The most common question from new practice owners is whether GOT is truly mandatory or whether it serves as a recommendation. The answer determines how the practice may handle discounts, package prices, and agreements with larger clients.
Regardless of the specific answer, the practice needs a procedure for documenting discrepancies. It must be possible to justify a fee adjustment retroactively, and that justification belongs in the medical record rather than in the memory of the person who issued the invoice.
Fee rate, the factor that determines the price
The base fee in the fee schedule is rarely the amount the pet owner actually pays. The veterinarian selects a multiplier—known in German as the “Gebührensatz”—which is multiplied by the base fee. The multiplier is intended to reflect how demanding the specific treatment was.
In practice, these are the practitioners who lose the most money, for two reasons. Those who habitually choose the lowest fee factor do not charge for complicated cases. Those who choose a high fee factor without the medical record showing why will have a hard time defending the bill when a pet owner questions it. A medical record entry describing what was done, how long it took, and what complications arose is the basis on which the fee factor is determined.
On-Call Services and Emergency Visits
Visits outside regular business hours are billed under different terms than daytime visits. The fee schedule includes rules for both a special on-call fee and a separate rate range for emergency visits.
For the practice, it is important that the medical records system knows when a visit took place. An emergency visit that is recorded as a regular daytime visit is billed incorrectly in both directions—either at too low a rate for the practice or in a way that the pet owner can justifiably object to.
What a valid invoice under GOT must contain
An invoice prepared in accordance with GOT must be understandable to the pet owner, a colleague, and the person auditing the practice. It lists each procedure separately, with a reference to the fee schedule item, the factor used, medications and supplies, and sales tax.
A lump-sum payment without a breakdown cannot be verified, and it makes it impossible to determine afterward whether a procedure was performed but not recorded. The more closely the invoice matches the medical record, the fewer disputes arise at the front desk.
The medical record determines the invoice
A procedure that isn’t recorded in the medical record rarely ends up on the invoice. That’s the simple explanation behind most of the missed billing in a veterinary practice. During a rushed appointment, the veterinarian has to treat the animal, talk to the owner, and move on to the next patient—and anything that wasn’t written down at the time gets lost.
This is where AI-powered medical record-keeping makes a difference for billing. Vetz listens during the conversation with the pet owner and creates a structured draft of the medical record, which the veterinarian reviews, approves, and transfers to the medical record system. The process is described in detail on the page about AI medical record-keeping. Once the medical record is complete, so is the invoice.
Vetz also offers a billing assistance feature that provides automatic suggestions for what should be billed based on the contents of the medical record, with the aim of reducing the risk of missed charges. The suggestions come directly from the medical record, so the procedure described in the note appears as a suggestion when the invoice is being prepared. Learn more about how it works on the page about billing in veterinary clinics.
Vetz integrates with Provet Cloud, Vettigo, and MHK FileMaker. Appointments are automatically displayed in Vetz, and the completed medical record is sent back to the medical record system without any manual steps. The practice itself determines which fee codes and factors are set up in that system, and anyone who wants to know if their own medical record system is supported can contact Vetz.
What Changed with GOT 2022
GOT was revised in 2022, and the revision affected both the base fees and several of the rules regarding billing. For a practice that established its price lists before the revision, there is good reason to review them again.
The practical work following a revision takes place in the medical records system. Fee codes, standard factors, and templates for routine visits need to be updated, and staff need to know what the new rules are. A practice that continues to bill according to an older version often does so without realizing it, since the invoice looks the same as before.
Common Problems and Information for Pet Owners
The errors that recur in billing under GOT are rarely complex. The practice charges below the rate out of old habit. VAT is handled incorrectly for certain categories of items. Services that were actually performed are missing from the invoice because they were never entered into the log. The pet owner has no idea of the cost until the invoice is on the counter.
The last mistake is the one that costs the most in terms of trust. A pet owner who has received a cost estimate before treatment rarely objects to the final bill, whereas one who is caught off guard is likely to question every line item.
Regardless of what the regulations require, it is good practice to have a procedure in place whereby the cost is reviewed before treatment begins and that procedure is documented in the medical record.
Checklist for the Internship Supervisor
An effective GOT billing system relies on procedures rather than on the memory of individual employees. The following points cover most of the essentials.
- Enter the fee schedule items and the practice's standard factors into the medical records system so that each procedure can be selected from a list rather than being entered manually.
- Determine how discrepancies should be explained and where the explanation should be recorded, so that it remains in the record if the invoice is disputed.
- Train everyone who issues invoices on what the fee schedule requires to be included on the invoice, including how medications, supplies, and sales tax are reported.
- Before treatment, discuss the costs with the pet owner and note in the medical record that this has been done.
- Regularly review a sample of invoices against the journal entries and look for services that were performed but not billed.
- Let the medical record drive the billing process, with a draft medical record created during the visit and a billing tool that suggests entries based on the record's content.
- Review price lists and templates after every change to the fee schedule, and verify that the system is using the current version.
Additional features that affect record-keeping and invoicing are listed on the page detailing Vetz's features.
Learn more about Vetz
Would you like to see how a draft medical record created during a visit can serve as the basis for an invoice, and how the billing support feature suggests entries directly from the medical record? Book a demo, and we’ll show you how Vetz works in a practice that bills according to GOT.