Mental health providers: frequently asked questions about the CM benefit of psychological care

No, no agreements have been concluded with CM since 01-01-2022. From 2022, we will follow the recognition conditions of the Federal Public Service for Mental Health Professions and will no longer have our own recognition criteria.

If you do not have either recognition number, but you meet the FOD recognition conditions for a psychotherapy practitioner, you can submit an application via [email protected] to obtain a recognition number. You can subsequently mention this approval number on the application form to open up the right to reimbursement for your clients.

To apply for a FPS visa number, we refer you to the FPS Health website where you can read all the information. Depending on the type of visa you wish to apply for, click on one of the following links:

• a clinical psychologist with a FPS visa number ;
• a clinical orthopedagogue with a FPS visa number .

The CM reimbursement for psychological care does not include any change in the number of reimbursable sessions and the reimbursement rate. The history of psychotherapy sessions already reimbursed to the member will be included in 2023. The number of refunded sessions continues to count.

No, only one refund can be made per session.

For treatments from January 1, 2023, reimbursement is also possible for sessions with a clinical sexologist recognized by VVS.

Within healthcare we distinguish three types of insurance:

• Mandatory insurance
  This statutory insurance is part of social security and is available to every resident of Belgium. This is managed by the Belgian National Institute for Health and Disability Insurance or Riziv. The health insurance funds have been appointed by the Riziv for the payment of reimbursements that fall under this statutory health insurance.
  The recent communication about the modified ELP project ('To the psychologist for 11 euros.') is located below.
  Current status of this modified ELP project . If the health insurance funds can provide clear and conclusive information to healthcare providers in this regard, we will of course do this as quickly as possible. We are currently awaiting approval from the Riziv for this.
   
• Additional insurance
  This is the package of additional services and benefits offered by the health insurance funds. The CM benefit of psychological care is located below.
  A member of a health insurance fund can make use of this by paying an annual membership fee/contribution. Since 2019, a resident of Belgium is obliged to join a health insurance fund and to determine the membership fee for this. The choice of which health insurance fund you wish to join is free.
  Each health insurance fund determines the composition of the package of additional services and benefits on the basis of an extensive financial plan. This package is financed by contributions paid by members. As a result, the membership contribution, the composition of the package, the conditions and the reimbursement of benefits may differ per health insurance fund.
   
• Optional insurance
  These are insurance policies that members can freely choose to take out, for example hospitalization insurance. In addition to hospitalization insurance, CM also offers additional insurance for medical costs without hospitalization: CM-MediKo Plan .

The reimbursement is granted for the treatment or guidance of mental health problems for which no intervention is provided by compulsory health insurance. Diagnosis and evaluation sessions are also reimbursable.

All dependent children up to the age of 25 or members who can demonstrate that they are still entitled to child benefit at the time of the first session.

After an interruption of more than three months after the previous session, we speak of a new treatment. The status will be checked again at that time.

CM offers a balanced package of additional services and benefits, where we try to do something for all members. We realize this package with the membership contributions that we collect from all our members. We spend these contributions entirely on benefits with which we want to make a difference for as many members as possible. The principle of solidarity plays a role here: members contribute to the financing of our offer and use it depending on whether they have costs related to illness and health.

Every year we evaluate and review our package of CM services and benefits. We focus on an offer that allows us to achieve the greatest health effect for members. We want to be there for our members when they need us most. At the same time, we also take into account that our members mainly expect reimbursement for high medical costs. There are many needs in healthcare. When putting together our package, we therefore have to make choices so that the membership contribution remains affordable.

That is why we chose this year to also provide reimbursement for first-line services so that more treatments are eligible. And the choice was not to expand the rate and the number of reimbursable sessions. We will adjust rates for adults in 2023 with the aim of providing more clear communication to our members.