Physiotherapy: common treatments
This concerns benefits in kind included in art. 7, §1, 1° of the nomenclature. The application rules are in art. 7, §10.
The benefits in kind for current physiotherapy are treatments that do not fall under:
- serious ailments ;
- treatments F-acute ;
- treatments F-chronic ;
- perinatal physiotherapy ;
- benefits in kind for palliative home patients ;
- sessions during day hospitalization.
Maximum number and nomenclature
You may charge a maximum of eighteen sessions per calendar year and for the same pathology:
- up to and including the 9th session: 567011, 567055, 567092, 567136, 567232;
- from the 10th to the 18th sessions: 560011, 560114, 560210, 560313, 560534;
- from the 1st to the 18th session: 560416, 564395, 560571.
A medical prescription is sufficient for the first series of eighteen regular sessions during a calendar year. No prior application is required.
If the treatment of the same pathology requires more than eighteen sessions during the same calendar year, it can be continued from the 19th session with excess sessions with reduced reimbursement (560055, 560151, 560254, 560350, 560453, 564410 or 560615).
- The exceedance sessions certified until July 31, 2021 are unlimited .
- From August 1, 2021, a maximum of 54 exceedance sessions per calendar year can be certified, regardless of the number of pathological situations.
Surcharge for starting an extensive physiotherapy file
The surcharge for starting a physiotherapy file for common conditions is integrated into the nomenclature under the heading 'Intake of the patient at the first session of a treatment'.
Surcharge for the first benefits in kind
The surcharge for the first treatment services for common conditions has been integrated into the nomenclature by creating new benefits from the first to the ninth session in current pathology.
Request additional hearings
In the event of a new current pathology during the same calendar year, the advising physician may allow additional sessions on the basis of a request .
The advising physician may authorize a series of eighteen additional regular sessions twice per calendar year. You may not charge for additional sessions before the advising physician has given permission . The approval of the advising doctor for eighteen additional benefits does not prevent you from certifying any balance of the eighteen previous benefits.
Submit the application by letter , addressed to the advising physician.
That request contains :
- or an application form, drawn up by you, with:
- your credentials;
- patient data;
- summary of the successive pathological situations and date of occurrence;
- your signature;
- copies of the prescriptions for the treatments;
- or a report from the treating physician with the successive pathological situations and date of occurrence.