Cost for Fitness Check

Dr. med. Ingo Hartenstein
specialist general medicine
emergency medicine - sports medicine - chirotherapy

Costs

Frequently questions are asked about the extensiveness and the costs of a diving medical examination and certification. Here are a couple of answers:

Like the water, me as a diving physician, I do not distinguish between sports divers and professional divers. I examine and treat them all the same. This is on the basis of the rules given by the divers occupation cooperative society and the German Armed Forces. It goes slightly beyond the standards set by the GTÜM (Gesellschaft für Tauch- und Überdruckmedizin, Diving- and Hyperbaric Medicine Society) and is thus a little bit more extensive.
I want to see a chest X-ray photograph in two projections (frontal and side) and results of some blood and urine examinations in order to exclude or rate major diseases or abnormalities of the lung and other organs with a reasonable probability.

As I am not owner of an X-Ray machine or a laboratory, these examinations have to be made at your family practitioner or at the X-Ray specialist (and payed directly to them). They should not be older than half a year. I will then analyze the pictures and the laboratory findings during the medical examination.

The billing is made according the „GOÄ“ (Gebührenordnung für Ärzte, official medical fee schedule). This specifies a fee for each medical service. The physician can multiply this with a factor ranging from 1 to 2,3 without further justification. If multiplied by a number between 2,4 up to 3,5 this needs sound justification. More than 3,5 is not allowed.

What does such an examination cost?

Laboratory examinations:

Examination	GOÄ Nb.:	Amount: (€) (multiplied by 1,3)
Blood count	3550	4,03
Electrolytes	3555 - 3558	ca. 8,70
CRP	3524	6,71
CK	3590H1	2,68
Gamma-GT	3582H1	2,68
GOT	3594H1	2,68
Creatinine	3585H1	2,68
Urinalysis (Stick)	3652	2,35
	Sum:	ca. 32,51

X-Ray examination:

Examination:	GOÄ Nb.:	Amount: (€) (multiplied by 2,3)
Chest, 1 projection	5135	29,83

Other examinations:

Examination / service (partially modified for better understanding)	GOÄ Nb.:	times 1 (€)	times 1,7 (€)	Times 2,3 / 1,8 (€)
Medical advice, also via telephone	1	4,66	(times 2,3) 10,71	(times 3,5) 16,31
Physical examination (Whole body including neurological status, ear examination, chest, abdomen, musculo-skeletal system and documentation)	8	15,16	25,76	34,86
Short certificate	70	2,33	3,96	5,36
Spirometry w. documentation in physical rest	605	14,11	18,34	25,39
Documentation of breath-flow	605a	8,16	10,61	14,69
Electrocardiographical examination (ECG) in physical rest	651	14,75	19,17	26,54
For an ECG during ergometry number 652 needs to be charged instead of 651
Electrocardiographical examination (ECG) during defined physical stress (ergometry)	652	25,94	44,09	59,66

The examination including exploration, physical examination, ECG and ergometry (for people elder than 40 or with higher physical risks) takes between one and two hours.

Thus is the total cost of a diving medical examination for persons below the age of 40:

	88,51 €
plus laboratory examinations	32,51 €
plus X-Ray examinations	59,66 €
total:	180,78 €

For people above 40 another 24,92 € (44,09 € minus 19,17 €) need to be added for the ergometry (minus ECG in rest which is included in the ergometry). This gives a grand total of 205,70 €

These calculations (excluded the special anamnesis and examinations by other doctors) are based upon a multiplier of 1,7.
Own errors, alterations of GOÄ or typing errors excepted.

Please take the following into consideration:
A kit for ergometry costs between 3.000 and 6.000 €. Annual maintenance costs range between 200 and 300 €. A reasonable spirometry-kit costs about 500 €. And by the way: how much did your last car inspection cost ;-) ?