After decades of immobility, the Italian healthcare system is preparing for a significant change. From the December 30, 2024, the new Tariff Decree of the Ministry of Healthapproved by the State-Regions Conference, will update the nomenclatures of outpatient and prosthetic specialist services, a intervention awaited for 28 years for the former and 25 for the latter.
This update, which will involve both the public and accredited private sectors, introduces some new services freeothers subject to tickets, redefining and expanding the essential levels of assistance (Lea): there will in fact be 2108 more updated services. The provision, the result of collaboration with the Mef, represents a revision of the decree already issued on 23 June 2023.
The review involves 1,113 tariffs out of 3,171 total services, with an increase of 550 million euros compared to the 2012 parameters. Compared to the 2023 decree, the additional economic impact is 147.3 million, intended for more adequate reimbursements for public and private operators.
The introduction of these innovations promises to mark a change, but the gap between ambitions and reality remains evident. Only a truly effective biennial review, as expected from 2025, will be able to demonstrate whether the decree truly represents the beginning of a healthcare system finally capable of meeting needs.
New tariffs, old battles
After decades of stalemate, the revision of 1,113 out of 3,171 tariffs has arrived, equal to 35% of the total: not a trivial thing, given that it is a update expected since 1996 for outpatient specialists and since 1999 for prosthetic assistance. Compared to 2012, government resources increase by 550 million euros, but the comparison with the 2023 decree reveals an additional cost of 147.3 million.
Some Regions, such as Lombardy, ask for flexibility in maximum tariffs to respond to local needs. The decree also provides a extension for prescriptions issued before December 30th 2024, valid until 12 months after entry into force, with possible extension for a further six months.
This increase, according to the government, should ensure fairer reimbursements for accredited public and private structures.
However, sector associations remain skeptical about the real sustainability of a system that struggles to balance new investments with now chronic structural problems. Underfunding (the controversies behind the funds allocated for healthcare in the 2025 Budget Law are not new) and the interminable waiting lists continue to represent a concrete obstacle, putting access to services for many families at risk. Even with the new decree, the issue of resources risks transforming what appears to be a turning point into a missed opportunity to revive public health.
A renewed approach to healthcare
The new nomenclature was born from an in-depth analysis of the data provided by all the Regions and Autonomous Provinces, with a focus on the real costs of services, the result of collaboration between public and private structures and sector organisations. The result is one proposal approved by the National Tariff Commissionwhich marks a step forward in resource adaptation.
On the prosthetics front, the innovations are significant for people with disabilities: the new price list includes for the first time devices such as eye communicators, adapted keyboards, digital hearing aids, sensors for home automation control and latest generation artificial limbs. The guaranteed services also include advanced voice recognition and eye tracking systems, expanding access to technologies that concretely improve the quality of life.
More inclusive and uniform essential levels
The new decree aims to reduce regional disparities in access to Essential Levels of Assistance (Lea), standardizing healthcare services across the national territory. Among the introductions stand out medically assisted procreation, the diagnosis of celiac disease and rare diseases, neonatal screening and cutting-edge technologies in radiotherapy, such as hadrontherapy and robotic systems. Diagnostic imaging and genetic counseling are also finally finding a more equal distribution.
In the prosthetic sector, the price list updates the offer with latest generation digital devices, including advanced hearing aids and home automation control aids. Added to these are communication tools adapted for the most serious disabilities and innovative prostheses equipped with technologies such as voice recognition, significantly improving autonomy and quality of life.
What’s new in 2025: healthcare that looks to the future
The decree is not just an update, but a change of direction for the healthcare system. From 2025, a biennial review of tariffs is planned, based on the actual costs recorded, to maintain a sustainable balance between expenses and reimbursements, thus improving the efficiency of the public and private service. But let’s now look in detail at what we are talking about and where we can find the main news.
Until this year, many of these services were paid entirely by the patient. With the new decree, they pass under the coverage of the National Health Service. They will not necessarily be free, but those who use them will eventually only have to pay one ticket, avoiding the full cost of the surgery.
Diagnostics and specialists: the new frontiers
The services introduced mark a leap towards the medicine of the future, with a focus on increasingly advanced diagnoses and therapies in these sectors:
- Innovative technologies: from enteroscopy with an ingestible microcamera for non-invasive explorations to the extension of neonatal screening, now capable of identifying pathologies such as SMA.
- Precision diagnostics: cutting-edge tools to monitor rare diseases and celiac disease, guaranteeing faster and more reliable tests.
- Pma accessible everywhere: medically assisted procreation becomes uniform on a national scale, eliminating regional disparities.
- Advanced radiotherapy: techniques such as stereotaxis, hadrontherapy and robotic radiotherapy are officially included among the therapeutic options.
- Celiac disease: advanced diagnostics to monitor the pathology over time.
- Rare diseases: targeted performance for diagnosis and monitoring.
- Diagnostic imaging: precision technologies for faster and more reliable results.
- Newborn screenings: extended to identify new pathologies, such as spinal muscular atrophy.
Prosthetics and aids: towards greater autonomy
Prosthetic innovations and assistance in general improve the autonomy and quality of life of people with disabilities:
- Communication devices: eye communicators and adapted keyboards designed for those with serious motor difficulties.
- Inclusive home automation: sensors and environmental control systems through the gaze, to make the home a more accessible environment.
- Technologically advanced prostheses: artificial limbs and new generation digital hearing aids are fully included among the guaranteed benefits.
- Intelligent assistive technologies: voice recognition and eye pointing systems that expand the possibilities of interaction for people with severe disabilities.
- Digital hearing aids: advanced hearing solutions.
