Beware of phishing. CM never sends you e-mails with requests to alter your personal details. How can you spot a fake e-mail?

Logo Christelijke Mutaliteit

Speech therapy disorders

As a speech therapist you will find here all speech therapy disorders for which the health insurance reimburses (Article 36 of the nomenclature).

Speech therapist reimbursement conditions
Find a speech therapist

In this section you will find an overview of all speech therapy disorders for which health insurance reimburses. Each sheet is drawn up according to a clear pattern with a number of fixed sections such as the type of hearings, the maximum number of hearings and a checklist for a complete and correct application.

Nomenclature (art. 36 §2, a)

Oral language or speech disorder that limits the ability to:

  • a profession that makes him subject either to the social security of employees or to the social status of self-employed persons; the job seekers are equated with that category of entitled persons;
  • retraining permitted by the Board of Medical Directors;
  • an apprenticeship agreement that has been recognized in accordance with the conditions laid down in the regulations regarding the continuous training of the middle class.

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions

  • Maximum 55 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Exclusions

Students cannot claim a refund.

In addition, all exclusions from §3 remain applicable.

Request checklist

The application for compensation must contain the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b1)

Language or speech disorders : aphasia, more specifically: acquired language disorders as a result of a brain injury of vascular, toxic, tumoral, infectious or traumatic origin.

Type of sessions

Individual sessions of thirty or sixty minutes and collective sessions of sixty minutes are permitted.

Maximum number of sessions

  • The treatment can be extended after the two-year continuous period, up to a total continuous period of up to four years from the start of the treatment reimbursed by CM, but an agreement is only given for one year at a time.
  • Maximum 288 sessions , spread over a continuous period of four years.
  • For therapeutic reasons, thirty-minute sessions may be replaced by sixty-minute sessions (except for children under ten years of age), without exceeding the equivalent of a maximum of 288 individual thirty-minute sessions.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximums for individual sessions of thirty minutes for relapse must be reduced by two sessions if a relapse balance sheet has been certified (issue 704115 – 704126).

Exclusions

No refund is possible for stays in:

  • psychiatric care home (PVT) (725xxx…);
  • rest home for the elderly (ROB);
  • rest and care home (RVT).

In addition, all other exclusions from §3 remain applicable.

Important

  • Start treatment
    Treatment should begin within six months of the onset of the condition.
  • Relapse
    If the maximum number of reimbursable sessions has not been used during the first period, it is possible to give a new agreement in the event of a recurrence provided the conditions are met.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (NKO/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, geriatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Etiology, nature and extent of the disorders.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b2)

Disturbances in receptive or expressive language development demonstrated by a language test with a result lower than or equal to the third percentile, with no intelligence impairment (total IQ 86 or more, measured with an individual test) and no severe hearing impairment (the average hearing loss does not exceed 40 dB HL at the better ear). The tests must appear on an exhaustive list approved by the Commission for Agreements.

Type of sessions

Only thirty-minute sessions are allowed.

Maximum number of sessions

  • Maximum 190 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximum number of sessions must be reduced by the number of parent guidance sessions charged:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • The maximums for individual sessions of thirty minutes for relapse must be reduced by two sessions if a relapse balance sheet has been certified (issue 704115 – 704126).

Exclusions

No refund is possible for:

  • speech disorders such as sigmatism, rhotacism, lambdacism, kappacism, cluttering;
  • an application following speech therapy treatment of B3 (learning difficulties) ;
  • language disorders as a result of learning a language other than the mother tongue or a multilingual upbringing.

In addition, all exclusions from §3 remain applicable.

Important

  • Late administration of IQ test
    No approval can be given for the treatment of language development disorders before the date on which the IQ was measured.
    Example: request for speech therapy with a start date of February 15. On February 28, the advising doctor will receive the results of the IQ test conducted on February 20. Approval can only be given from February 20.
  • Extension of treatment
    Tests in function of an extension must also be part of the exhaustive list.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.
  • Relapse
    If the maximum number of reimbursable sessions has not been used during the first period, it is possible to give a new agreement in the event of a recurrence provided the conditions are met.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.

  • Results of a language test carried out before the speech therapy treatment was prescribed and included on the exhaustive list of which at least two subtests were administered. At least one subtest must demonstrate a result less than or equal to percentile three.
    If a test is part of a test battery, one must:

    • administer two subtests from the same battery;
    • use another test from the exhaustive list to complete the assessment.

    The list of these test batteries can be found in the exhaustive list of tests .

  • Already included in the standard template 'bilan voor speechtherapie'.
I.Q
  • The total IQ, measured by an individual test that appears on the exhaustive list, is 86 or more.
  • The application includes:
    • the name of the test used;
    • the precisely expressed figure of the total IQ;
    • the date of collection.
Audiogram
  • The average hearing loss in the better ear should be less than 40 dB HL.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (NKO/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine, surgery.
  • Identification and signature of the prescribing physician.
  • The prescription confirms the treatment proposal made in the speech therapy evaluation report.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

 

Nomenclature (art. 36 §2, b3)

Dyslexia, dysorthography or dyscalculia, in children up to and including the day before the 15th birthday , who have received at least six months of primary education , must be proven by the following characteristics, all of which must be described in the balance sheet :

  • a performance deficit demonstrated by tests in reading and/or written expression and/or arithmetic that yield two scores less than or equal to percentile 16 or less than or equal to at least one standard deviation;
  • a persistence of the disorders.

The tests must correspond to the year in which the beneficiary is enrolled and appear on an exhaustive list approved by the Agreements Committee.

In addition, the following characteristics must be reported in the balance sheet:

  • level of accuracy and/or speed (=automation);
  • phonological development (only for dyslexia and dysorthography);
  • compensatory behaviors, negative attitude, increased effort.

Type of sessions

Only individual sessions of thirty and sixty minutes are permitted.

Maximum number of sessions

  • Maximum 140 sessions , spread over an uninterrupted period of two years.
  • For therapeutic reasons, the thirty-minute sessions may be replaced by sixty-minute sessions (except for children under ten). However, the equivalent of 140 or 192 sittings may not be exceeded.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The prescribing doctor must not specify the duration of the sessions in the prescription.
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximum number of sessions must be reduced by the number of parent guidance sessions charged:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • The maximums for individual sessions of thirty minutes for relapse must be reduced by two sessions if a relapse balance sheet has been certified (issue 704115 – 704126).

Exclusions

No refund is possible if:

  • the beneficiary attends special education (not even during holiday periods);
  • the disorders are a consequence of learning a language other than the mother tongue or of a multilingual upbringing;
  • the disorders are the result of psychiatric disorders or emotional states, of relationship problems, of neglected or inadequate school attendance.

In addition, all other exclusions from §3 remain applicable.

Important

  • Age restriction
    Speech therapy treatment must start before the age of 15, so the assessment must also be completed before the fifteenth birthday. The beneficiary is entitled to two years of reimbursement from the date of payment by the insurance institution (even if the age of the person concerned exceeds 14 years).
  • Extension of treatment
    Even in the event of an extension, the prescription for the treatment must be based on a test from the exhaustive list.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.
  • Relapse
    If the maximum number of reimbursable sessions has not been used during the first period, it is possible to give a new agreement in the event of a recurrence provided the conditions are met.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Two scores must be less than or equal to percentile 16 or one standard deviation.
  • At least one test from the exhaustive list .

    • If a test is part of a test battery, one must:

      • administer two subtests from the same battery;
      • use another test from the exhaustive list to complete the assessment.

      The list of these test batteries can be found in the exhaustive list of tests (dyscalculia, dysorthography, dyslexia).

    • If a short test was administered, it must be supplemented with another test from the exhaustive list.
  • Information regarding:
    • a persistence of the disorders and/or
    • problems at the level of accuracy and/or speed (= automation) and/or
    • phonological problems (only for dyslexia and dysorthography) and/or
    • compensatory behaviors, negative attitude, increased effort.
  • Already included in the standard template 'bilan voor speechtherapie'.
  • Prescription for speech therapy treatment
     
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • The prescription confirms the treatment proposal made in the speech therapy evaluation report.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b4)

Disorders due to cleft lips , cleft palate or cleft tooth sockets .

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions

  • Age-related
    • Children under 3 years old
      One agreement for a period up to and including the day before the third anniversary.
      Maximum number of sessions: thirty individual sessions of at least thirty minutes.
    • Children from 3 to 19 years old
      Eight agreements, each lasting a maximum of one year. A shorter period is also possible.
      The chords do not have to match each other.
      Maximum number of sessions: 75 individual sessions of at least thirty minutes.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Important

  • Unused sessions
    The unused sessions in the context of an annual agreement cannot be carried over to a subsequent period.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b5)

Acquired disorders as a result of radiotherapeutic or surgical treatment (head and neck).

Type of sessions

Only individual sessions of thirty minutes and collective sessions of sixty minutes are permitted.

Maximum number of sessions

  • Maximum 55 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b6.1)

Acquired speech disorders : traumatic or proliferative dysglossias, more specifically disorders resulting from a structural anomaly (congenital, traumatic or tumoral) of the peripheral organs of articulation.

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions

  • Maximum 149 sessions, spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b6.2)

Acquired speech disorders : dysarthria, more specifically acquired motor speech disorders due to central or peripheral nerve damage.

Type of sessions

Only thirty-minute sessions are allowed.

Maximum number of sessions

  • Maximum 176 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Important

  • Cumulative ban
    For example, a beneficiary who exhibits dysphagia and dysarthria cannot obtain approval for both disorders. The application must be made on the basis of the most pronounced disorder.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Duration of treatment.
  • Number of sessions for the requested period.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b6.3)

Chronic speech disorders:

  • due to neuromuscular disorders included in the list used by the reference centers for neuromuscular disorders,
  • or as a result of Parkinson's disease or Huntington's disease,
  • or as a result of cerebral palsy in children up to the age of 3 years, certified by a neurologist,
  • excluding dementia or symptoms of early dementia.

Type of sessions

Only individual sessions of thirty minutes are permitted.

Maximum number of sessions

  • Spread over a continuous period of two years, a maximum of 520 sessions are permitted. Afterwards, an agreement for 260 sessions can be given per year for any possible extension.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Extension

The duration of reimbursement for the treatment of chronic speech disorders is not limited to two years. A new approval can be given each time if a new speech therapy treatment can significantly improve the speech disorder.

Important

  • Neuromuscular disorders
    The term 'neuromuscular disorders' does not refer to conditions that are either solely neurological or solely muscular in nature. The relevant neuromuscular diseases are listed on this page of the Riziv website (non-exhaustive list).
  • Number of balances
    The evolution balance sheet (704012 – 704082) may be certified a maximum of three times a year if they have been prescribed and are part of an agreement from the advising physician.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a doctor specialist in neurology or pediatric neurology, and this - if the etiology is MS, neuromuscular diseases or cerebral palsy - in the context of his activity in a rehabilitation center contracted with the Riziv or with the federated entities specialized in the integral care of patients with these conditions.
  • Identification and signature of the prescribing physician.
  • Etiology, nature and extent of the disorders.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b6.4)

Stuttering. The severity of stuttering is measured by a test that appears on an exhaustive list approved by the Commission for agreements with speech therapists. The score on the test must be stated on the written report of the assessment.

Type of sessions

Both individual sessions of thirty minutes and individual and collective sessions of sixty minutes are permitted.

Maximum number of sessions

  • Maximum 128 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximum number of sessions must be reduced by the number of parent guidance sessions charged:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • The maximums for individual sessions of thirty minutes for relapse must be reduced by two sessions if a relapse balance sheet has been certified (issue 704115 – 704126).

Important

  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.
  • Relapse
    If the maximum number of reimbursable sessions has not been used during the first period, it is possible to give a new agreement in the event of a recurrence provided the conditions are met.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the test that appears on the exhaustive list and was carried out before the speech therapy treatment was prescribed.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, b6.5)

Frequent functional disorders in relation to an orthodontic disorder .

Type of sessions

Individual sessions of thirty minutes are permitted.

Maximum number of sessions

  • A maximum of twenty sessions are permitted during a single continuous period of twelve months.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Important

  • Cumulative
    At the same time, approval can be given for speech therapy treatment of other disorders mentioned in Article 36 §2 and disorders in the context of interceptive orthodontic treatment. But only one session per day can be reimbursed.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • An orthodontist or dentist is therefore not allowed to prescribe a bilan.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a doctor specialist in oto-, rhino-, laryngology (ENT/ORL) or stomatology, by a general dentist or a dental specialist in orthodontics.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, c1)

Acquired voice disorder: sequelae of laryngectomy.

Type of sessions

Individual sessions of thirty minutes and collective sessions of sixty minutes are permitted.

Maximum number of sessions

  • Maximum 90 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, c2)

Dysfunction of the larynx and/or vocal folds demonstrated on the basis of:

  • laryngoscopy and stroboscopy
  • and perceptual data, acoustic and aerodynamic measurements with tests and criteria included in the committee-approved list of tests for voice disorders
  • and measurements of the impact of the voice problems on the patient's quality of life using tests and criteria included in the Approved List of Tests and Trials for Voice Disorders.

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions

  • A maximum of eighty sessions are permitted over a continuous period of two years.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximum number of sessions must be reduced by the number of parent guidance sessions charged:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • The maximums for individual sessions of thirty minutes for relapse must be reduced by two sessions if a relapse balance sheet has been certified (issue 704115 – 704126).

Exclusions

Voice disorders such as acute functional aphonia (no voice), dysphonia (hoarseness), phonasthenia (voice weakness) and voice alternation disorders are not eligible.

In addition, all other exclusions from §3 remain applicable.

Important

  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.
  • Relapse
    If the maximum number of reimbursable sessions has not been used during the first period, it is possible to give a new agreement in the event of a recurrence provided the conditions are met.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • The following investigations must be carried out:
    • laryngoscopy and stroboscopy by an ENT doctor;
    • auditory-perceptual assessment of the voice;
    • psychoacoustic measurement of voice;
    • measuring the impact on quality of life.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, d)

To the beneficiary with hearing disorders that involve an average hearing loss of at least 40 dB HL in the better ear.

Type of sessions

Only individual sessions of thirty minutes are permitted.

Maximum number of sessions

  • A maximum of 520 sessions are permitted over a continuous period of two years. Afterwards, an agreement for 260 sessions can be given per year for any possible extension.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximum number of sessions must be reduced by the number of parent guidance sessions charged:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.

Important

  • Extension
    The continuous period of two years may be extended on the basis of a prescription from the rehabilitation specialist affiliated with a conventional rehabilitation center specialized in the treatment of these conditions. The treatment can be extended as often as necessary.
  • Cumul rehabilitation center
    Patients with hearing disorders must follow or have followed a rehabilitation program with speech therapy in a conventional rehabilitation center that is specialized in treating these problems. One can therefore follow both mono- and multidisciplinary therapy in the same period but not on the same day.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a doctor specialist in oto-, rhino-, laryngology (ENT/ORL), neurology or pediatric neurology. The prescriber must be affiliated with a conventional rehabilitation center specialized in these problems.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, e)

Dysphagia that threatens oral nutritional and fluid intake or with a risk of aspiration.

Type of sessions

Only individual sessions of thirty minutes are permitted.

Maximum number of sessions

  • Maximum 65 sessions , spread over an uninterrupted period of two years.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximums for individual sessions of thirty minutes for relapse must be reduced by two sessions if a relapse balance sheet has been certified (issue 704115 – 704126).

Children under three years old

For children under 3 years of age for whom a fluoroscopic examination (VFES or FEES) cannot be performed, the file must be sent to the health insurance fund's advisory physician, stating the reasons.

The file is then submitted to the Commission for agreements with the speech therapists.

The file must contain the following elements to be eligible:

  • medical justification as to why neither of the two stated objective examinations can be carried out on the child;
  • all data from the patient's medical file that are directly or indirectly related to or could explain the disorder for which reimbursement is requested;
  • therapeutic plan of the proposed swallowing rehabilitation, which at least states how the feeding process is stimulated, on the basis of which improvement is expected and how the risks are estimated.

Important

  • Evolution balance sheet
    An evolution balance sheet can be certified a maximum of three times a year.
  • Relapse
    If the maximum number of reimbursable sessions has not been used during the first period, it is possible to give a new agreement in the event of a recurrence provided the conditions are met.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Prescription from a general practitioner or specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Result of the fluoroscopic examination
 
  • One of the following studies is attached to the prescription:
    • VFES (Video Fluoroscopic Evaluation of Swallowing);
    • FEES (Fiberoptic Endoscopic Evaluation of Swallowing).
Prescription for speech therapy treatment
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (NKO/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, geriatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature (art. 36 §2, f)

Severe expressive and/or receptive language disorders that persist beyond the fifth birthday and seriously interfere with social communication and/or daily activities involving oral language, in the absence of a pervasive developmental disorder, a hearing disorder (the average hearing loss is at the best ear not more than 40 dB HL), an intelligence disorder [performance or non-verbal IQ or OQ (developmental quotient) of 86 or more, measured with an individual test] or an environmental deficit that can explain the dysphasia.
 

The disorder must be demonstrated by means of individually administered standardized tests for which the results for at least one aspect (expressive or receptive) in at least three domains [phonology (including metaphonology), vocabulary/semantics, morphology, syntax] are less than or equal to two standard deviations below the mean. These tests must appear on an exhaustive list approved by the Commission for agreements with speech therapists.

Type of sessions

Individual sessions of thirty and sixty minutes are permitted.

Maximum number of sessions

  • Spread over a continuous period of two years, a maximum of 384 thirty-minute sessions are permitted. Afterwards, an agreement of 96 thirty-minute sessions can be given per year for any possible extension up to and including the age of 17.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.
  • The maximum number of sessions must be reduced by the number of parent guidance sessions charged:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.

Maximum duration of the agreement

  • Phase 1
    Agreements of up to one year, spread over an uninterrupted period of two years.
  • Phase 2
    Possible extension for periods of one year, up to and including the age of 17, and on the condition that the person concerned continues to follow normal education (i.e. not special education).

Exclusions

  • Speech disorders such as sigmatism, rhotacism, lambdacism, kappacism, cluttering.
  • Language disorders as a result of learning a language other than the mother tongue or a multilingual upbringing.
  • An application F that follows speech therapy treatment of B3 (learning problems).
  • All other exclusions from §3.

Important

  • Place of treatment
    During the continuous period of two years, the beneficiary may only be treated at school five times per calendar month. Sessions at school are no longer permitted after the uninterrupted period of two years.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Drawn up by a pediatric neurology specialist.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Speech therapy assessment
  • The child must be at least 5 years old at the time the assessment is drawn up.
  • The history proving the absence of environmental factors that could explain the dysphasia.
  • Results less than or equal to two standard deviations (≤ pc3) for a language test that appears on the exhaustive list (cf. test sheets) for three of the four domains:
    • phonology (including metaphonology);
    • vocabulary/semantics;
    • morphology;
    • syntax.
  • Report of the tests carried out before the prescription of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
Audiogram
  • Average hearing loss does not exceed 40 dB HL in the better ear.
Intelligence quotient
 
  • Performance or non-verbal IQ or OQ (developmental quotient) is 86 or more, measured with an individual test that appears on the exhaustive list .
Prescription for speech therapy treatment
 
  • Drawn up by a pediatric neurology specialist.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Nomenclature

Speech, swallowing and language disorders related to Locked-in Syndrome (LIS).

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions

  • Spread over an uninterrupted period of one year, a maximum of 150 sessions of at least thirty minutes are permitted.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • An agreement may be given for all extensions for a maximum of one hundred sessions per year of at least thirty minutes.
  • The evolution balance sheet session does not count towards calculating the maximum number of reimbursable sessions.

Request checklist

The refund request must include the documents below.

  
Application form or standard template 'bilan voor speechtherapie'
 
  • Application form: signed and dated by the patient or his legal representative.
  • Standard template: signed and dated by the speech therapist, the prescribing physician and the patient or their legal representative.
Prescription for speech therapy bilan
  • Drawn up by a general practitioner or a specialist doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Medical certificate
  • Drawn up by a medical specialist in neurology, neuropsychiatry, pediatric neurology or neurosurgery, who certifies that the patient suffers from Locked-In Syndrome
Speech therapy assessment
  • Report of the tests
  • Dated before the implementation of the bill.
  • Already included in the standard template 'bilan voor speechtherapie'.
Prescription for speech therapy treatment
 
  • Drawn up by a doctor specialist in neurology, neuropsychiatry, pediatric neurology or neurosurgery
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.

Also read

Speech therapist reimbursement conditions
Discover them here