In September 2025, the European Commission published a Trend Report on cross-border patient healthcare in the EU, covering the years 2021–2023. The report highlights key developments in cross-border patient mobility and spending.
First, in the period under consideration, almost 12.000 requests for prior authorisation were made (under the Cross Border Healthcare Directive 2011/24/EU). The number of requests rose sharply over the period, from 1.456 in 2021 to 4.552 in 2022 and 5.973 in 2023. Prior authorisation is a formal permission from the country of affiliation for the assumption of planned cross-border care costs. Approximately 5 out of 6 of these requests were accepted; most refusals occurred when equivalent treatment was available in the patient’s home country within a medically acceptable time frame. Germany received more than half of these requests (6.691), while Czechia and Germany were the two countries that treated the most cross-border patients (1.435 and 1.426 respectively).
During the same period, there were about 1,4 million reimbursement requests for healthcare not requiring prior authorisation. More than three-quarters were approved. Germany received the most requests for reimbursement (324.790) while Spain treated the most patients (234.635 cross-border patients received between 2021 and 2023).
The financial implications of cross-border healthcare show that at least €465 million was spent on cross-border healthcare during this period. Of this, roughly €19 million (4%) covered treatments requiring prior authorisation, while the remaining €446 million was spent on treatments not subject to authorisation.
For full details, see the European Commission’s Trend Report here.
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