What is the Telematikinfrastruktur and why does it apply to allied health providers?
The Telematikinfrastruktur is a secure, certified network through which healthcare providers can communicate digitally – from GPs and pharmacies to physiotherapy practices. It is operated by gematik GmbH, a company with federal government involvement, and its core purpose is to enable the secure exchange of patient data, reduce administrative burdens, and improve care quality.
For allied health providers, TI connection has been a statutory requirement since 1 January 2024 (§ 291 para. 2b SGB V). Every licensed practice, regardless of size, must be connected via an approved access point. Providers who do not comply face a one per cent deduction on all statutory health insurance billings, applied for as long as the connection remains absent and unverified.
- ✓Legal basis: § 291 para. 2b SGB V (mandatory from 01.01.2024)
- ✓Penalty: 1% deduction on GKV reimbursements if connection is missing
- ✓Affected: all licensed allied health providers (physio, OT, SLT, podiatry, etc.)
- ✓Operator: gematik GmbH
Which components are required for TI connection?
The classic TI connection via a stationary connector requires three core components: the connector itself, an institutional smart card (SMC-B) for the practice as an entity, and an electronic health professional card (eHBA) for each individual therapist who actively uses TI-enabled services.
The connector is a hardware device that physically links the practice to the TI network. It must be installed by a certified service provider and kept up to date. The SMC-B is the practice's institutional card, proving to the TI that the facility is licensed. The eHBA is personal: it identifies the individual therapist and will be required to sign electronic prescriptions or access the electronic patient record (ePA).
Not every TI application immediately requires an eHBA. For the Versichertenstammdatenmanagement (VSDM) – verifying patient health insurance card data – the SMC-B is often sufficient to begin with. However, the eHBA becomes mandatory once the electronic prescription (eVO) is rolled out.
- ✓Connector: certified hardware access point, requires regular updates
- ✓SMC-B: institutional card for the practice (ordered from approved card issuers)
- ✓eHBA: personal health professional card for each active therapist
- ✓VSDM: active immediately – automated verification of health insurance data
Alternative: TI access via RISE – no hardware required
Not every practice needs or wants to operate a stationary connector. For practices seeking a flexible, hardware-free solution, gematik has approved cloud-based alternatives that replace the on-site connector entirely. One such provider is RISE Health, which offers a certified connector-as-a-service solution.
The advantages are clear: no hardware procurement or maintenance costs, automatic updates, and location-independent access – particularly valuable for practices with multiple sites or therapists who work in different locations. Relocation or expansion no longer triggers a hardware logistics project.
TheraNext integrates TI connectivity natively via RISE. Practices using TheraNext can activate TI access directly within the software – no hardware, no on-site installation, no separate integration project. In day-to-day use, workflows remain familiar; they simply become digitally secured and legally compliant.
Applying for the eHBA: step-by-step
The eHBA is obtained not from a GP or health insurer, but from a gematik-approved card issuer (Trustcenter). Several certified issuers currently serve allied health providers, each with their own online application portal. Applicants specify their professional title; membership of a professional chamber is not a prerequisite for allied health providers, unlike for physicians.
After submitting the application, identity verification takes place via video identification or PostIdent. The eHBA is then sent by post together with a PIN letter. Delivery times vary by issuer and current demand, and can run to several weeks. It is strongly advisable to apply early to avoid reimbursement deductions caused by delays.
Each therapist in the practice who will actively use TI services requires their own eHBA. One card cannot be shared. The SMC-B for the practice is applied for separately from an approved issuer, through a distinct application process.
- ✓Step 1: Select a gematik-certified card issuer
- ✓Step 2: Submit online application with professional title and personal details
- ✓Step 3: Identity verification via video ID or PostIdent
- ✓Step 4: Receive eHBA and PIN letter by post, then activate
- ✓Note: allow several weeks lead time – apply early!
Costs of TI connection and reimbursement by health insurers
TI connection generates costs in two categories: one-off set-up costs and ongoing running costs. For licensed allied health providers, the GKV-Spitzenverband has established a reimbursement framework covering both a one-time set-up payment and ongoing operational cost contributions.
The exact amounts are set out in the framework agreements under § 125 SGB V and vary by profession and insurer. Reimbursement is contingent on the connection actually being in place and verifiable. Practices that have not connected receive neither reimbursement nor protection from the billing deduction.
For practices using a cloud-based TI service such as RISE, upfront hardware costs are eliminated. Monthly service fees are generally reimbursable to the extent they fall within contractual operational cost parameters. The eHBA also incurs annual fees which may likewise be reimbursable under the applicable framework agreement.
VSDM and further TI applications in day-to-day practice
The first actively usable TI application for allied health providers is VSDM. At each appointment, the patient's electronic health card is inserted into a card reader and the insurance data are verified online with the relevant health insurer. This automatically checks whether the insurance is still active and whether coverage details have changed.
For the practice, this means less manual data maintenance, fewer billing errors, and automatic protection against billing for patients whose insurance has lapsed. VSDM verification is already mandatory and should be carried out at each patient's first visit as well as at regular intervals thereafter.
Beyond VSDM, further TI applications are increasingly relevant: KIM for secure digital messaging between providers, and access to the electronic patient record (ePA) where patients have consented. Most of these applications require the eHBA and will become a standard part of therapeutic practice in the coming years.
Looking ahead: the electronic prescription (eVO) from 2027
The next major step is the electronic prescription for allied health services (eVO). The eVO replaces the existing paper referral from the prescribing physician with a digital data record transmitted via the TI and read directly into the practice management system. Mandatory rollout is planned for 2027, with pilot regions already under way.
In practical terms: no more prescriptions that patients lose or forget. No more illegible handwriting. No more manual data entry. Prescription data arrive directly in the scheduling and billing modules, transcription errors are eliminated, and billing accuracy improves substantially.
A fully functional TI connection including an eHBA is a prerequisite for using the eVO. Practices that establish their TI connection now will be compliant in 2026 and technically ready for the eVO obligation in 2027. TheraNext will support the eVO natively from the moment the official rollout begins – prescriptions will be received, verified, and converted into treatment series directly within the system.
Checklist: getting your TI connection right first time
TI connection requires lead time. Working through the steps below in the right order avoids the most common delays and protects against reimbursement deductions. In particular, the eHBA application should be submitted as early as possible, since delivery timelines from card issuers can vary.
Practices with multiple therapists should ensure that all relevant staff have applied for their eHBA in good time. For practices using cloud-based software such as TheraNext, the process is particularly straightforward, as TI and RISE connectivity are integrated directly into the software with no separate hardware project required.
- ✓Apply for SMC-B from an approved card issuer
- ✓Apply for eHBA for all active therapists (allow for delivery time!)
- ✓Set up connector or RISE cloud access
- ✓Activate VSDM and use it in daily practice
- ✓Submit reimbursement claim to health insurer
- ✓Check eVO readiness: eHBA available, software TI-compatible?
- ✓Train the practice team on TI workflows and data protection
Written & reviewed by
TheraNext Fachredaktion
Digitalisation & Practice Management for Allied Health Providers