SK Official website

Pilot2 Frequently Asked Questions (FAQ)

1. General information

Which specialized expertise does Pilot2 involve?

In cooperation with professional working groups and health insurance companies, MZ SR selected in the second phase pilot of expertise angiology, endocrinology, paediatric endocrinology and diabetesology, diabetes, rheumatology, paediatric rheumatology, clinical immunology and allergology, clinical oncology, otorinolaryngology, cardiology, paediatric cardiology, nephrology, paediatric nephrology.

Why was I selected to participate in Pilot2? Who selected the Pilot2 providers?
Was the choice of providers transparent, or on what basis were providers selected?

Providers included in the pilot were selected by health insurance companies on the basis of the following criteria:

Where should I turn if I am interested in taking part in the second pilot testing of the new performance list?

Providers included in Pilot2 are selected by health insurance companies on the basis of several criteria. The candidate for inclusion in Pilot2 will receive an invitation letter for cooperation in the pilot project. There is no need to send a request to health insurance companies or to MZ SR.

Was the choice of provider according to the provider's ID or code of practice?

Healthcare providers are selected for Pilot 2 as an IČ, but reporting and analysis will take place at the 12-digit code of the healthcare provider in piloting expertise.

What's the pilot's target2?

Test New List of health performances in practice, get feedback and background for its fair pricing. Get the most realistic description of the activities provided by the doctor and nurse in the ambulance, get data on the frequency of new performances, verify the time-consuming performances and calculate new weights of health performances based on real data.

What is expected of me as a pilot2 provider?

When will Pilot2 start and how long will it take?

I've been hearing about the new CSR for years. This is just some sort of MZ activity...

MZ SR has not only CSR published on the website of MZ SR, but also time data about how much it takes. However, it does not have data on the possible frequency of individual performances or the total capacity of PSS to perform new performances. The aim of this phase of the project is to get the most realistic description of the activities provided by the doctor and nurse through the new codes, to get data on the frequency of new performances, to verify the time-consuming performances and then to calculate the weights of health performances (medical-economic comparison of individual performances between each other within one expertise and among the expertise) based on real data. Without this step, it is not possible ultimately to re-set the fair pay of outpatient healthcare providers.

Because of the large number of patients, we also investigate them outside of outpatient hours. We are concerned that this will appear to have taken disproportionately short time in the analyses compared to the official office hours.

It is precisely because of the non-conformity of real working time with office hours within the pilot that a record of the real working time of doctors working in individual offices is also introduced through web-formular on the website of MZ SR - monthly statement of hours worked - https://verifications.pilotkony.sk/. Report to the health insurance company all care provided by you and state the actual time during which you provided the healthcare in the monthly statement of hours worked for the Slovak Ministry of Health.

2. New List of Health Performances

Which performances should I perform during Pilot2?

Where can I find the current list of new performances?

Consolidated list of health performances for pilot is published on https://pilotvykony.sk/. This list includes all health performances for the second pilot phase of health performance testing, which were approved by the Commission for health performances and management of MZ SR.

Where I find the division of new and old performances so I can better navigate
in the matter?

Complete list of performances for outpatient healthcare is published on the website NCZI.
Performances intended for piloting are indicated in the last column of the table by the letter "P'. For better orientation on the subject, online reporting seminars will be organised for each piloted expertise.

Will there be a bridge between old and new performances?

No. The aim is, through the new classification of outpatient performances, to faithfully describe real medical work without the effects of previous (often deformed) reporting practice.

What should I do if I do not find a performance in the new CSR to describe the health care I have provided?

Check again the consolidated list of health performances for the pilot, which could in the meantime be updated on the website MZ SR. Page https://pilotvykony.sk/ in Pilot2 - Frequently Asked Questions (FAQ) are also published e-mail contacts of competent persons for each piloted expertise, which you can consult medical questions. If you still do not find the right performance, please contact == sync, corrected by elderman ==. Please describe in detail the lack of health care, if any, with regard to other performance or frequency.

Do we also have performances that are not covered by public health insurance?

Yes. These data are also necessary in particular at the analytical stage to evaluate the total workload of the piloting provider.

I found some mistakes in the new CSR. Where should I report this?

Thank you, the purpose of the pilot is also to correct typos and minor errors in the lists. Please write your suggestion as accurately as possible== sync, corrected by elderman ==. To speed up communication, please indicate your ID or provider code to the subject of the email message.

3. Remuneration, reimbursements and other contractual terms

If I am a provider who received an invitation to cooperate with the pilot from MZ SR2, do I have to have a contract signed?

Yes, if, in connection with the invitation to cooperate from MZ SR, you have confirmed your interest to join the pilot by filling in the appropriate webformulár MZ SRAll 3 health insurance companies They will send you an individual draft supplement to the healthcare contract. Its main subject will be an agreement on the amount of the monthly lump sum payment.

How will the reimbursement of the healthcare provided by the piloting provider take place?

During the pilot operation, you will have a fixed monthly payment in each health insurance company, which will take into account your expected performance, applying the higher prices for 2026 and the incentive fee of 1 000 € per month. By means of a lump-sum monthly payment, your financial income will be stable and predictable. The first invoicing for April 2026 will take place in early May.

Will the provider who will be involved in the pilot project be financially remunerated for participating in the pilot?

Yes, for the pilot's cooperation, the pilot's provider will receive 1 000 € each month for each skill you fly. The reward is financed by all three health insurance companies (VZP 560 €, Trust 330 €, Union 110 €).

Are children's and basic expertise counted separately?

No, for the purposes of motivational rewards, they are considered as one expertise.

How do health insurance companies calculate the flat rate?

The flat-rate payment consists of two components:

How much should I invoice to the health insurance company for the last calendar month? Do I invoice specifically the average monthly amount and especially the incentive reward?

You will invoice to the health insurance company the amount specified in the supplement to the healthcare contract you have concluded with it. This amount is the sum of your average monthly reimbursement and incentive fee.

Is it possible to fly with a reduced work schedule?

Yes, the amount of flat-rate reimbursement reflects the real performance of PBS without further consideration of the doctor's commitment.

The CBP did not work for several months because of the TN. It assumes that the calculation also included the above mentioned period when it had zero revenues and this affected the final value of the flat-rate.

The monthly flat rate was calculated depending on the performance of the piloted expertise in the period from 01/2025 to 12/2025, the sum of the performance of each month being calculated by the number of months in which the provider effectively invoiced. This means that the period during which health care was not reported due to PN did not have a negative impact on the calculation of the flat rate.

The amount of flat-rate payment from the health insurance company does not match my calculations.

Please contact a specific health insurance undertaking for clarification on the e-mail contact:

Can I choose to join Pilot 2 with only one or two health insurance companies?

No. For the successful evaluation of piloted expertise reporting, it is essential that the provider displays the same treatment to all three health insurance companies.

Can Pilot2 be financially disadvantageous for some providers? Can it happen that by joining Pilot2 I will have lower premiums from insurance companies than when I was not in Pilot2?

Given the methodology for calculating the flat rate, including the financial reward, the pilot provider is not expected to achieve a lower income than without being involved in the pilot. In addition, by way of lump-sum reimbursement, the financial income of the provider will be stable and predictable. In case of discrepancies and ambiguities, please contact the health insurance company at the e-mail contact mentioned above.

What if PCS pilots more expertise or operates more ambulances in one specialist or employs more doctors on ambulances?

If one provider (IRO) pilots more expertise, one flat-rate calculated as the sum of the performance of the individual piloted expertise + a reward of 1000 € x the number of piloted expertise is requested in the health insurance company. The level of remuneration does not therefore depend on the number of ambulances or doctors, but is linked to the expertise as such.

What is being covered beyond the flat-rate?

Do the new IPP and bonus payments from ZP apply?

No, the flat-rate payments were also calculated by applying IPP and bonuses.

What if I focus on the time-consuming primary investigation of new patients (in anticipation of this coming from us) and the number of treated patients falls by more than 25%? Will the malus health insurance company apply and take the incentive payment?

The contractual clause on -maluse-of-health insurance companies were introduced in the Appendices only for the purposes of internal justice of the piloting providers. It would not be fair to leave the same amount of reimbursement to the piloting PCS and providers who are satisfied with a regular flat-rate payment without providing evaluable data to the project. We do not expect that the number treated will fall below 75% of the normal reporting of the entire pilot operation period by preference for new examinations prior to the control or impact of holidays. It compares the number of birth numbers treated in the piloting period with the number of DETs treated in the same period last year. If, by chance, yes, the facts worthy of special consideration will be taken into consideration in favour of CSR.

Can the health insurance company terminate my contractual relationship with me if I am involved in Pilot2?

Only in the case of a breach of general contract terms which apply generally, not specifically in connection with the pilot. We are convinced of your interest in testing new health performances in order to best serve all healthcare providers in the future. We are therefore open to deal with all the knowledge and suggestions that we will gain from you during the pilot phase.

4. Technical issues

Are the providers' information systems ready for the new health performance list?

Project intentions were communicated in 12/2025 with all information system providers:

The degree of comfort for the piloter depends on the capacity of the Vendor.

The healthcare provided during Pilot2 is shown to health insurance companies in the standard dose or should I report MZ SR? What's the procedure?

The health care awarded shall be reported by the provider in the form of electronic benefits to each health insurance undertaking by default.

As a pilot, must I send or report anything else in addition to the standard benefits I send to health insurance companies?

Yes, you will fill in the web form on the website of MZ SR once a monthRegistration of a monthly statement of hours worked(sssssssssssssssssssssss) in which you state the sum of the hours worked by the doctor according to the days of the month.

Is it necessary to record something in eHealth?

Yes, in accordance with current legislation after the provision of healthcare, the provider will create an entry in the patient's electronic health book. This functionality is provided automatically Your suppliers of the information system (vendori).

How will performance reviews by health insurance companies take place with the pilot provider?

Only within the scope of the column "Implementation and reporting of ZV' in the new CRR.

What happens if the health insurance company rejects one of the reported performances?

The reason for the refusal shall be stated in the relevant protocol. Also in Pilot2, you are expected to receive a corrective dose.

What is the procedure if the doctor has two expertise and only one is piloted? What will be the procedure for unpiloted expertise?

In case of unpiloted expertise the health insurance undertaking shall pay as it has done. Piloted expertise shows PZS new performances and ZP pays the flat-rate. The reporting and reimbursement mechanisms of both models are unrelated. Invoices can be one or two (as is easier for CSS), health insurance companies can process them.

Will the 753b benefit that doctors send to insurance companies look anything different than the previous one? Will the new pilot CSR be in common with other performances?

Dose 753b is unchanged. The PBS involved in the pilot operation only shows new performances in one batch. If such a PBS needs to report CPCs provided to EU policyholders etc., it shows them in the second dose, i.e. it does not mix new and old performances in a single dose.

Why are the citizens of Ukraine in the exemption? When, let us say, a person with a permanent or temporary residence in Slovakia is employed, he pays normal contributions, has absolutely normal insurance regardless of whether he is a citizen of Ukraine, Czech Republic or Slovakia. There is no difference in the policyholder's card.

If you have met with information about specific health care reporting to citizens of Ukraine in the accompanying documentation to the piloting project of the new CSR, this is meant only by citizens with assigned status of temporary refuge, asylum or subsidiary protection. Such treatments shall only be reported to the General Health Insurance Institution according to the instructions published on https://www.vszp.sk/ukraine/#dl3

5. Practical reporting

Because of the large number of patients, we also investigate them outside of outpatient hours. Should we only report to the health insurance company what we can do during official office hours?

Pilot2 is expected to best describe your real medical practice through new performances. Therefore, please report to the health insurance company all the care you have provided. It is precisely because of the mismatch between real working time and office hours that a pilot also introduces a record of the real working time of doctors working on individual offices through a web-formular on the MZSR website Þ 🙂Registration - monthly statement of hours worked" - https://verifications.pilotkony.sk/.

Some procedures should be reported with the administered medicinal product. What if I'm not using the A medicine, but the master? How do I report it, so that I don't get denied payment of the ZP's power?

For the purpose of Pilot2, only A and AS-medicines, medical devices and special medical supplies shall be reported as add-on items.

Original performances 250A and 250B were replaced by one code in the new performance list. Will there no longer be a distinction between the performance for blood sampling and the number of test tubes?

No, it is a single exercise of blood sampling regardless of the number of applications/tests.

In the list of general performances there are no performances in the case of more difficult performance (original performances 64, 65, 66).

Additional performances do not enter payment for CPC under Pilot2. They will be dealt with by the relevant gesorical expert working groups after the launch.

What is the difference between 1C04006 and 1C04004?

Both performances are intended for the administrative treatment of a repeat prescription, each with different times of use (or DP, ZP):
1C04006 - patient taking more than three months
1C04004 - patient taking at least one month
In the performance of 1C04006, the patient is not physically present; in the performance of 1C04004, the patient may be physically present, but in both cases the patient does not currently need an examination. Therefore none of the performances can be combined with other outpatient performances (reported separately).
For repeated regulations during the check in the ambulance, these codes are not reported, the rules are included in the main performance.

6. Ambulances of constitutional health institutions

In the offices of the constitutional health institutions, two doctors with different ties cover the same office code. How will the analyses differ that it was the production of two doctors at one office and not the higher production of one doctor?

A monthly statement of the hours worked by doctors working in individual offices is also introduced under Pilot2. The report is designed to capture individually the working time of each of the doctors working in parallel on one of the occupational codes. The production will therefore be analysed correctly.

What about constitutional health institutions reporting new outpatient health services for hospitalized patients?

Basically, nothing changes. You show new health performances that will be managed as standard for hospitalized patients. However, they will be recorded for the purposes of Pilot2.

How are we supposed to perform consiliatory examinations in hospitals?

An outpatient examination of a patient hospitalised in another healthcare facility is, from the perspective of the new CSR, a standard outpatient examination of the insured person, thus showing new performance. From the point of view of the DRG, this is the provision of an extramural CPC which will be settled with the hospital in which the patient is hospitalized.
The provision of the so-called intramural CPC, i.e. the outpatient CPC provided to hospitalized patients in the same hospital as the clinic, is also shown by new CSR performances, but are not covered by the DRG principles. Hospitals which, by reason of their non-reimbursement to intramural CPCs, do not recognise insurance undertakings, should take into account the need to comply with the performances reported to insurance undertakings with the monthly statement of hours worked for ISR. The options are two:

7. Further information and support

Who will provide me with methodological support, in cases where I am not sure when describing medical activity?

For better orientation on the subject, online reporting seminars will be organised for each piloted expertise. At the same time, in the case of medical questions about new health performance, they have individual expertise of their clinical leaders, which you can consult with their questions:

Further suggestions and questions we recommend to address to contact email == sync, corrected by elderman ==with an indication of your ID or PCS code.

Who can I turn to if I have a question I haven't found in the FAQ?

Further suggestions and questions we recommend to address to contact email== sync, corrected by elderman ==with an indication of your ID or PCS code.

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