In the former German Federal Committee of SHI (-accredited) Physicians and Health Insurance Funds (Bundesausschuss der Arzte und Krankerkassen) a full paradigmatic change was initiated in 1990 by establishing the NUB Committee (NUB = New Methods of Diagnosis and Treatment). The NUB committee and its successor, the Federal Joint Committee (Gemeinsamer Bundesausschuss; G-BA), extended the basis of their decision making process. In order to evaluate new methods of diagnosis and treatment, the methods of Evidence-based Medicine (EbM) were increasingly taken into account aiming to establish a readjusted set of criteria for the evaluation and introduction of new diagnostic and therapeutic methods. In the beginning the criteria of Evidence-based Medicine (EBM) were applied to the methods of medical diagnosis and treatment only, but in the meantime have consistently been extended to also cover the evaluation of new physiotherapeutic therapies, psychotherapeutic treatments and measures of early diagnosis and screening, the costs of which are reimbursed by the statutory health insurance (SHI). The methodology of the G-BA is in compliance with the international standards of EbM and Health Technology Assessment (HTA) and is the mandatory basis of its work, laid down in its code of procedure. This article gives a detailed description of its mode of operation, reflecting in addition the work of similar institutions in other countries with often comparable modes of operation.