Physiotherapy: treatments F-acute
Reimbursement is possible for certain conditions as an F-acute condition.
Certain conditions occur suddenly and require intensive treatment for a short period of time. These conditions may be treated as F-acute. They are stated in art. 7, §14, 5° A of the nomenclature; the provision codes in art. 7, §1, 5°.
Maximum number and nomenclature
An F-acute treatment lasts a maximum of one year (365 or 366 days), from the date of the first session.
During this period , a maximum of sixty sessions will be reimbursed (563010, 563113, 563216, 563312, 563415, 564572, 563496 and 563570). A maximum of 120 sessions will be reimbursed for the treatment of polytraumatism (pathology 16) only.
If the treatment of the same pathology requires more sessions than the maximum during the same year, the treatment can be continued from the 61st or 121st session with a reduced reimbursement (563054, 563150, 563253, 563356, 563452, 564594 or 563533).
Surcharge for the first benefits in kind
The allowance will be integrated into the nomenclature for the first treatment benefits for F-acute conditions by creating new benefits from the first to the twentieth session F-acute.
Notification
For each pathology you must send an F status notification to the CM's consulting physician. No refund is possible until the consulting physician has received a valid notification.
The notification must contain the following information:
- the patient's identification details;
- your identification details;
- the start date of the treatment;
- the pathology treated;
- confirmation that you have a prescription and that you know the standards for care.
The notification is invalid if you modify the text, add comments, fill in the form incompletely or use a different form.
Extension
Once the year of treatment has ended, the pathology is no longer recognized as F-acute. An extension is therefore not possible . Any additional sessions must be charged as regular physiotherapy.
Request additional hearings
If a new pathology F-acute occurs during the same year of treatment (year of notification), the consulting physician may authorize additional sessions on the basis of a request .
That request contains:
- a notification of the new pathology;
- a report from the treating physician with the successive conditions and their date of onset;
or
a report from you, drawn up on the basis of the regulations, with an overview of the successive conditions and their starting date + copies of the regulations.
The period of the previous notification ends the day before the new pathology starts, regardless of the number of billed sessions.
In the event of a first new current pathology (which has nothing to do with the current F-acute) during the current calendar year , no request for additional sessions is required (possibility to charge for eighteen current sessions in addition to the F sessions).
From a second new current pathology during the calendar year or in the case of an F-chronic condition , a request for additional sessions is required, as well as a notification for the F-chronic treatment. The regulations of both the current F-acute and the current sessions must be added to this application. You may not charge for additional sessions before the advising doctor has given his approval.