Oral care process
The amount of the personal share for an oral care program depends on the reimbursement of dental care provided the previous year.
Due to the oral care process, the amount of the personal share depends on the reimbursement of dental care (only services referred to in Article 5 are eligible) carried out in the previous year .
As a result of the corona crisis, this amount in 2024 exceptionally depends on the reimbursement of dental care performed in 2023 or 2022. This exceptional measure will stop from 2025 and will therefore only take into account the reimbursed dental care that was provided in 2024.
Which dental care does this affect?
The oral care process has an impact on the following provisions of Article 5:
- conservative care;
- extractions;
- radiographs (except for patients with increased reimbursement);
- dental prostheses;
- oral implants;
- emergency supplements.
The oral care process does not affect the following provisions of Article 5:
- consultations;
- preventive treatments;
- periodontics;
- specific dental care services for cancer patients or anodontics;
- orthodontics;
- for patients with increased reimbursement: radiographs and some additional fees (adhesive techniques, rubber dam, wound suture).
Which patients does this apply to?
The oral care process only applies to patients aged 18 and over.
How much is the personal share?
The co-payment may be rounded up to x.00 euros or x.50 euros.
Without an oral care program in the previous year , the personal share increases:
- doubling (or approximately) for conservative care, extractions, denture treatments and emergency supplements;
- 1.50 times more for radiographs, adhesive techniques/cofferdam and wound suturing;
- 40.50 euros more for the installation of prostheses and oral implants.
Examples:
| Provision | Oral care program followed in 2023 (or 2022*) | No oral care process in 2023 (or 2022*) | |
|---|---|---|---|
| Amounts valid from April 1, 2024. (VT = increased compensation) | |||
| 304312 | without VT | 105,00 - 92,00 = 13,00 euro | 105,00 - 79,50 = 25,50 euro |
| 303590 | without VT | 14,00 - 10,50 = 3,50 euro | 14,00 - 9,00 = 5,00 euro |
| 301011 | without VT | 30,00 - 24,00 = 6,00 euro | 30,00 - 24,00 = 6,00 euro |
| 306913 | without VT | 869,00 - 679,50 = 189,50 euro | 869,00 - 626,50 = 242,50 euro |
* As a result of the corona crisis, this amount exceptionally depends on the reimbursement of dental care provided in the past two years. For example, the reimbursement in 2024 depends on the reimbursement of dental care in not only 2023, but also 2022. This exceptional measure will stop from 2025 and will therefore only take into account the reimbursed dental care that was provided in 2024.
Without an oral care program in the previous year, the personal share increases by 1 euro .
For the installation of dental prostheses, oral implants and emergency supplements for urgent dental care, the personal share increases by 2 euros .
Examples:
| Provision | Oral care program followed in 2023 (or 2022*) | No oral care process in 2023 (or 2022*) | |
|---|---|---|---|
| Amounts valid from April 1, 2024. (VT = increased compensation) | |||
| 304312 | with VT | 105,00 - 105,00 = 0 euro | 105,00 - 104,00 = 1 euro |
| 303590 | with VT | 14,00 - 14,00 = 0 euro | 14,00 - 14,00 = 0 euro |
| 301011 | with VT | 30,00 - 30,00 = 0 euro | 30,00 - 30,00 = 0 euro |
| 306913 | with VT | 869,00 - 6844,00 = 25 euro | 869,00 - 842,00 = 27 euro |
* As a result of the corona crisis, this amount exceptionally depends on the reimbursement of dental care provided in the past two years. For example, the reimbursement in 2024 depends on the reimbursement of dental care in not only 2023, but also 2022. This exceptional measure will stop from 2025 and will therefore only take into account the reimbursed dental care that was provided in 2024.
What about the third-party payment scheme?
- Have you provided reimbursed dental care to your patient in the past year and are you sure that the oral care process has been followed? Then you may invoice according to the amounts of the oral care process .
- Do you not know whether reimbursable dental care was provided in the past year? Then charge the rates as if the oral care process had not been followed . If our data shows that the oral care process was nevertheless followed, we will pay the additional amount to the person concerned.
You can consult the rates via MyCareNet. The display automatically takes into account whether or not an oral care program has been followed (based on the data in our possession).