Physiotherapists
Yes that is allowed.
No, we only accept original applications.
No, an application must always be submitted on paper.
No, an application must always be submitted on paper.
Provide a completed F-acute list or F-chronic list .
Tip: enclose a copy of the prescription. This is not mandatory but it prevents problems.
- patient identification data;
- original version;
- on paper;
- overview of the different pathologies and the dates of their occurrence;
- drawn up by a physiotherapist or together with a doctor:
- drawn up by the physiotherapist: an overview of the various pathologies and the dates of their occurrence must be included, including copies of the various prescriptions;
- if the physiotherapist does not have the prescription(s) in his/her possession: application 'prepared' by a doctor or general practitioner: an overview of the various pathologies and the dates of occurrence must be included;
- signature and identification of the physiotherapist;
- the notification: appendix 5a or 5b.
- patient identification data;
- original version;
- on paper;
- drawn up by a physiotherapist or together with a doctor:
- drawn up by the physiotherapist: an overview of the various pathologies and the dates of their occurrence must be included, including copies of the various prescriptions;
- if the physiotherapist does not have the prescription(s) in his/her possession: application 'prepared' by a doctor or general practitioner: an overview of the various pathologies and the dates of occurrence must be included;
- signature and identification of the physiotherapist (and possibly GP).
This is a situation that occurs after the start of the physiotherapy treatment, during the same calendar year and that is separate from the original pathological situation. More information about interpretation rule 1 .
General: F acute cannot be prolonged.
- a)1: Orthopedics - value ≥ N200 and art. 14k (nomensoft Riziv):
- This does not include heart operations;
- Often admission to intensive care (admission report or prescription in file), then F05 (e.g. N2700) is possible;
- Examples: 290286 (good), 228266 (bad) -> F a)1;
- a)2B: Hand injuries = very specific situation, rarely occurs (several interventions must be involved that are added up with a formula);
- g)11: Peri-arthritis scapulohumeralis (PSH) does not always indicate a frozen shoulder.
The first application must be drawn up by a specialist doctor, possibly together with the required examinations (depending on the pathology).
If there is a specialist report, the GP may also prepare the application.
An extension may be requested by the GP, together with a recent functional assessment.
They can always be requested by the advising physician.
It is best to ask your patient whether he or she is already being treated by another physiotherapist or practice.
You can request this online via the secure MyCareNet portal site.
As a healthcare provider you can log in with your eID. As soon as you have been identified as a healthcare provider, you will be given access to the insurability data of the patient for whom you want to invoice medical services in the third-party payment scheme.
Some software have already integrated this function into their package.
The allowances and the benefits to which they relate must be attested on the same certificate.
There are three options:
- The full amount: including the co-payment, so that CM can check whether the maximum amount to be invoiced has been exceeded or not (see maximum invoice MAF, 4th Part, IV.);
- Yes: when you have received the amount in full;
- No: when no co-payment was paid.
More information can be found here: physiotherapists Riziv .
On 01-06-2021, new regulations came into effect with the integration of the allowances for current and F-acute conditions in the nomenclature. The surcharges for the first 9 (current) or 20 (F-acute) sessions were abolished. The amount of these allowances is integrated into the sessions. It is no longer possible not to certify the increased fees at the first hearings. There is therefore a distinction in terms of nomenclature number and amount for:
- Current sessions:
- separate codes for the first 9 sessions of a treatment;
- separate codes for the 10th to 18th session of a treatment.
- Sessions F-acute:
- separate codes for the first 20 sessions of a treatment;
- separate codes for the 21st to 60th (or 120th) session of a treatment.
On 01-06-2021, a new regulation came into effect with the deletion of the pseudocode from the file start-up. This has been replaced by a nomenclature code for the patient's intake.
- File start-up/intake can only be reimbursed once per calendar year, regardless of the number of pathological situations in that calendar year.
- File start-up/intake can only be certified at the first session of a treatment (this does not necessarily have to be the first session of the calendar year).
Example: file start-up 639855 in combination with session 560011 (and possibly allowance 562671) corresponds to performance codes 567033 (intake) and 567011 (session) in the new nomenclature. Since performance code 560011 in the new nomenclature is linked to the 10th to 18th session of a treatment, intake 567033 can only be certified in combination with performance code 567011 (1st to 9th session).
- If you enter 'yes' or the total amount, this will be registered for:
- the maximum invoice;
- any hospitalization insurance;
- CM-Mediko Plan;
- the CM benefit 'Reimbursement of co-payment for children under 6 years of age'.
- If you enter 'no' and still pay co-payments, this will not be registered correctly for the patient.
You may certify them if your patient has received the palliative lump sum and the treatment takes place at home.
You can find the overview in the Nomensoft of the Riziv under article 7 of the nomenclature or under 'fees, prices and allowances of physiotherapists' on the Riziv website .
We also offer you this handy overview . The table is only an aid and does not replace the authentic texts. The source for these nomenclature codes is the appendix to the Royal Decree of 14 September 1984 and its successive amendments as published in the Belgian Official Gazette.
If a patient with a B, C, Cd, D profile (ROB, RVT or CVK) resides in a Flemish institution, physiotherapy can no longer be provided via the nomenclature art. 7 physiotherapy may be charged. These services are financed by the Flemish government.
Billing via the nomenclature is still possible for patients with an A, O profile (ROB or CVK). In that case, you certify the nomenclature number for physiotherapy in a rest home for the elderly, regardless of the place where the treatment is provided. This means that if a rest home resident visits his own private physiotherapist outside the rest home, you as a physiotherapist must still certify the nomenclature numbers for physiotherapy in a rest home for the elderly.
An application must always be made on paper. Additional information about the application can be exchanged via email.
You may respond directly by email if a correction document is returned. The correction document does not need to be adjusted, but sometimes it is clearer to make corrections on the scanned certificate.
We only use email if we have a confirmed email address. Would you like to provide your email address so that CM can contact you by email in the future? Complete your contact details on our secure platform ProCM .
Hang this poster in your waiting room. Or order a copy by email from our relationship manager: [email protected] .
You can report this online with your eID.
As a physiotherapist, always contact the CM team in the region where you are located.
- Antwerp , Korte Begijnenstraat 22, 2300 Turnhout
- Medical administration: [email protected] and 03 221 92 97
- Invoicing third party payer on paper: [email protected] and 03 221 93 50
- Invoicing third party payer electronically (eFact): [email protected] and 03 221 93 49
- Limburg , Herkenrodesingel 101, 3500 Hasselt
- Medical administration: [email protected] and 011 28 04 95
- Invoicing third party payer on paper: [email protected] and 011 28 04 90
- Invoicing third party payer electronically (eFact): [email protected] and 011 28 05 32
- East Flanders , Martelaarslaan 17, 9000 Ghent
- Medical administration: [email protected] and 09 267 54 75
- Invoicing third party payer on paper: [email protected] and 09 267 54 08
- Invoicing third party payer electronically (eFact): [email protected] and 09 267 54 08
- Flemish Brabant and Brussels , Platte Lostraat 541, 3010 Kessel-Lo
- Medical administration: [email protected] and 02 240 86 15
- Invoicing third party payer on paper: [email protected] and 02 240 86 23
- Invoicing third party payer electronically (eFact): [email protected] and 02 240 86 23
- West Flanders
- Bruges , Oude Burg 19, 8000 Bruges
- Medical administration: [email protected] and 050 44 03 53
- Invoicing third party payer on paper: [email protected] and 050 44 75 57
- Invoicing third party payer electronically (eFact): [email protected] and 050 24 92 10
- Kortrijk , Beneluxpark 22, 8500 Kortrijk
- Medical administration: [email protected] and 056 52 64 85
- Invoicing third party payer on paper: [email protected] and 056 52 65 15
- Invoicing third-party payer electronically (eFact): [email protected] and 056 52 65 15
- Ostend , Ieperstraat 12, 8400 Ostend
- Medical administration: [email protected] and 059 55 26 47
- Invoicing third party payer on paper: [email protected] and 059 55 26 48
- Invoicing third party payer electronically (eFact): [email protected] and 059 55 26 48
- Roeselare , Beversesteenweg 35, 8800 Roeselare
- Medical administration: [email protected] and 051 75 00 15
- Invoicing third party payer on paper: [email protected] and 051 26 53 18
- Invoicing third party payer electronically (eFact): [email protected] and 051 42 38 11
- Bruges , Oude Burg 19, 8000 Bruges
We send every patient a letter entitled 'Allowance for flat rate home care'. We advise them to provide this letter to the physiotherapist and/or nurse when starting or following treatment.
If incorrect codes are certified, you will receive a correction document from CM.
Invoices and/or applications intended for another health insurance fund are systematically returned to the provider.
You send an email to our relationship manager: [email protected].
Our programs use your address as registered with the Riziv. The letters that 'run automatically' use that address. When contacting a healthcare provider, our employees sometimes register a different (more recent) address. We can only use this in programs that allow you to enter a different address.
For correct use of your postal address, it is best to change your address with Riziv.
Yes. Since October 1, 2015, you can do this for every patient.
You submit your certificates together with a completed summary statement to CM. You prepare the collective statement in duplicate.
This model summary statement contains all required elements.
If you submit your summary statement in duplicate, together with the certificates, to CM, you will receive the amount within thirty days.
We will provide you with an overview of the reduced or refused certificates. You will receive the rejected certificates back, with the reason for refusal.
Treatment must start within two months of the prescription being drawn up.
A prescription contains the following information:
- patient's name;
- diagnosis;
- location of the condition if not clear in the diagnosis;
- start date of treatment if this is not the date of the prescription;
- date of prescription;
- signature and stamp of the prescribing physician;
- additional elements:
- if a written report is requested or if a second session must take place per day;
- for notification F-acute: under points 1, 2, 2a and 3 you must state the number of the surgical procedure.