Payments and certificates

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 This has been replaced by a nomenclature code for the patient's intake.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.