Draft Decree updating national tariffs for outpatient specialist services formally approved in Italy

The Essential Levels of Care (LEA) framework defines the healthcare services and benefits that the National Health Service must guarantee. Annex 4 of the LEA catalog contains the national nomenclature of outpatient specialist services, including laboratory procedures, while Annex 5, List 1, covers custom-made prosthetic aids.

On July 23, 2026, the State-Regions Conference formally approved the draft Ministerial Decree updating the maximum national reimbursement tariffs for outpatient specialist services and custom-made prosthetic care provided in the Italian National Health Service under the LEA.

The update will replace the November 2024 tariff decree and is intended to better reflect current service delivery costs and to address the methodological concerns raised by the Lazio Regional Administrative Court regarding the previous tariff decree.

Tariffs were revised for 448 outpatient specialist services and 222 prosthetic-care codes with the following key changes:

• A weighted average increase of 5.8% across the affected specialist services;
• A higher reimbursement for initial specialist consultations, with an average tariff of approximately €26 and higher rates for certain specialties;
• Tariff increases for vascular diagnostics, nuclear medicine, Doppler ultrasound, endoscopy, electromyography, rehabilitation, and dialysis;
• An increase of approximately 15% for selected home-based peritoneal dialysis services; 
• Revised tariffs for a range of custom-made prosthetic care.

The overall estimated annual financial impact is €210.7 million, comprising approximately €183.1 million for outpatient specialist care and €27.6 million for prosthetic care.

The draft decree does not introduce a general increase in in-vitro diagnostic test tariffs.

The new tariffs are expected to take effect on September 21, 2026, subject to the final adoption and publication of the Ministerial Decree.

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