Third party payment scheme: what are the rates?
The co-payment varies depending on the patient's situation.
It is important to always check the correct rate (eTAR) .
If you invoice electronically, your software package often automatically shows which rates and co-payments should be charged.
Consultations with general practitioners
Co-payment | ||
|---|---|---|
| With raised compensation | Without increased compensation | |
| Patient without global medical record (GMD) | 1.50 euros | 6 euros |
| Doctor does not have access to the GMD | 1.50 euros | 6 euros |
| Doctor has access to the GMD | 1 euro | 4 euros |
| Amounts valid since December 1, 2011 | ||
Consultations with medical specialists
The co-payment is identical for all specialties :
- 3 euros for patients with increased reimbursement ;
- 12 euros for patients without increased compensation.
For a medical specialist in training, the co-payment amounts to:
- 2.25 euros for patients with increased reimbursement ;
- 9 euros for patients without increased reimbursement.
On-call consultations
For consultations during on-call shifts, you can also enter your invoices electronically in the third-party payment scheme.
This applies to all situations in on-call duty (on weekdays, at weekends, in the guard post itself or in the cabinet) or as part of an organized on-call duty .
Home visits
There is no uniform co-payment for home visits.
You can consult the rates via the calculation module on our site .
Maximum invoice ceiling has been reached
If your patient has reached the ceiling for the maximum bill (MAF), you continue to ask for the co-payment . So you cannot invoice CM for the full fee. The co-payment will be automatically refunded to your patient.
Don't forget to indicate that you have collected the co-payment. This can be done via:
- your software package if you invoice electronically;
- the box 'KB 15.07.2002' of the certificate for assistance provided if you invoice on paper.
