OBJECTIVES: Reimbursement of inpatient services in Germany is based on Diagnosis Related Groups (G-DRG). For new examination and treatment methods (NUB) which are not covered by G-DRGs appropriately an additional NUB remuneration is possible. Hospitals have to apply at the ‘Institute for the Payment System in Hospitals’ (IneK), which decides whether NUB remuneration is possible (status 1) or not (status 2-4). This paper analyses the development of NUB remunerations and their effects on stimulating medical advancement and innovation. METHODS: Based on the annually published data of § 6 Abs. 2 KHEntgG an analysis on the distribution of NUB status from implementation in 2005 through 2016 was conducted. Parameters of analysis were NUB status, number of inquiring hospitals, and NUBs differentiated in medical procedure, pharmaceuticals, and medical device. Additionally, the conversion into DRGs or additional fees was examined. RESULTS: Since implementation 7691 NUB applications for overall 3018 medical procedures, pharmaceuticals, and medical devices were filed at InEK, of which 58,7% account for medical producedures, 23% for pharmaceuticals and 18,3% for medical devices. The number of pharmaceuticals and medical products increased from 2005 through 2016 by 38% and 42%, respectively. With 38,9% pharmaceuticals are rated more frequently with NUB status 1 than medical products (13,3%) or medical procedures (12,2%). The incorporation of NUB into the G-DRG catalogue and repectively the creation of an additional fee was only carried out in 67 cases: 9 full G-DRGs, 37 additional fees for pharmaceuticals, 9 for medical devices, and 21 for medical procedures. CONCLUSIONS: Regarding the innovation capabilites of the German health care system the current configuration of the NUB remuneration is not fostering leading-edge technologies in inpatient services sufficiently. Especially medical products remain on a low level of positive assessment, despite increasing NUB applications and technological progress.