Selecting a language will automatically trigger the translation of the page content.

Reimbursement for a medical consultation

Verified 10 March 2020 - Directorate for Legal and Administrative Information (Prime Minister)

When you see a doctor, the amount of the reimbursement varies according to several criteria: coordinated care pathway, discipline (general or specialist) and the doctor's agreement.

The rules are different for a child under 16 years.

Respect of the route

All beneficiaries of Health Insurance are reimbursed partially for the costs of consulting a doctor.

Fees for physician visits differ depending on whether the physician is a general practitioner or a specialist. In addition, some specialists benefit from special tariffs: psychiatrists, neuropsychiatrists, neurologists, pediatricians and cardiologists.

Reimbursement for your consultation also varies depending on the type of doctor's agreement. The contracted doctor of sector 1 applies the tariff fixed by agreement with the sickness insurance. The contracted doctor of sector 2 practices free fees.

The correspondent doctor may be consulted for an ad hoc opinion with the agreement of your treating doctor. The doctor's rates are specific.

When you have declared a attending physician, you can consult directly some specialists (not need the agreement of your attending physician).

A contract for access to care is gradually being introduced. This contract governs fee overruns (they are authorized but limited). You can find out if your doctor has adhered by consulting the ameli.direct site.

Répondez aux questions successives et les réponses s’afficheront automatiquement

Attending physician

General Practitioner
Tableau - Rates and reimbursement of a consultation with a general practitioner

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€25

€25

€16.50

Sector 1 (complex consultation)

€46

€46

€31.20

Sector 1 (very complex consultation)

€60

€60

€41

Adhering to the contract for access to care

Fees with controlled overrun

€25

€16.50

Sector 2

Fees available

€23

€15.10

Specialist
Tableau - Rates and reimbursement of a specialist consultation

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€25

€25

€16.50

Sector 1 (complex consultation)

€46

€46

€31.20

Sector 1 (very complex consultation)

€60

€60

€41

Adhering to the contract for access to care

Fees with controlled overrun

€25

€16.50

Sector 2

Fees available

€23

€15.10

Psychiatrist, neurologist
Tableau - Fees and reimbursement of a consultation with a psychiatrist or neurologist

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€39.70

€39.70

€26.79

Sector 1 (very complex consultation)

€60

€60

€41

Adhering to the contract for access to care

Fees with controlled overrun

€39.70

€26.79

Sector 2

Fees available

€39

€26.30

Corresponding (regular) physician

General Practitioner
Tableau - Rates and reimbursement of a consultation with a general practitioner

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€26

€26

€17.20

Adhering to the contract for access to care

Fees with controlled overrun

€26

€17.20

Sector 2

Fees available

€23

€15.10

Specialist
Tableau - Rates and reimbursement of a specialist consultation

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€28

€28

€18.60

Adhering to the contract for access to care

Fees with controlled overrun

€28

€18.60

Sector 2

Fees available

€23

€15.10

Corresponding physician (one-time)

Specialist
Tableau - Rates and reimbursement of a consultation with a corresponding specialist on an ad hoc basis

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€50

€50

€34

Adhering to the contract for access to care

Fees with controlled overrun

€50

€34

Sector 2

Fees available

€50

€34

Psychiatrist, neurologist
Tableau - Fees and reimbursement of a consultation with a psychiatrist or a corresponding neurologist on an ad hoc basis

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€62.50

€62.50

€42.75

Adhering to the contract for access to care

Fees with controlled overrun

€62.50

€42.75

Sector 2

Fees available

€62.50

€42.75

Specialist

Gynecologist and ophthalmologist
Tableau - Rates and reimbursement of a consultation with a gynecologist or an ophthalmologist

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€28

€28

€18.60

Sector 1 (very complex consultation)

€46

€46

€31.20

Adhering to the contract for access to care

Fees with controlled overrun

€28

€18.60

Sector 2

Fees available

€23

€15.10

Psychiatrist (16 to 25 years)
Tableau - Fees and reimbursement of a psychiatric consultation (patient aged 16 to 25)

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€43.70

€43.70

€29.59

Sector 1 (very complex consultation)

€60

€60

€41

Adhering to the contract for access to care

Fees with controlled overrun

€43.70

€29.59

Sector 2

Fees available

€39

€26.30

Please note

some complex public health consultations (such as 1)era consultation with a girl aged 15 to 18 who wishes to obtain contraception) are taken care of at 100%.

Off-course

All beneficiaries of Health Insurance are reimbursed partially for the costs of consulting a doctor. Outside the care pathway, the reimbursement rate is 30% of the conventional tariff and the user fee is 70%.

Répondez aux questions successives et les réponses s’afficheront automatiquement

General Practitioner

Tableau - Rates and reimbursement of a consultation with a general practitioner (outside the care pathway)

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€25

€25

€6.50

Adhering to the contract for access to care

Fees with controlled overrun

€25

€6.50

Sector 2

Fees available

€23

€5.90

Specialist

Tableau - Rates and reimbursement of a consultation with a specialist (outside the care pathway)

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€33 minimum

€25

€6.50

Adhering to the contract for access to care

Fees with controlled overrun

€25

€6.50

Sector 2

Fees available

€23

€5.90

Psychiatrist, neurologist

Tableau - Fees and reimbursement of a consultation with a psychiatrist or a neurologist (outside the care pathway)

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€52 minimum

€39.70

€15.71

Adhering to the contract for access to care

Fees with controlled overrun

€39.70

€15.71

Sector 2

Fees available

€39

€14.9

Cardiologist

Tableau - Rates and reimbursement of a consultation with a cardiologist (outside the care pathway)

Sector

Rate

Reimbursement Basis

Amount refunded (after deduction of the €1)

Sector 1

€58 minimum

€45.73

€21.01

Adhering to the contract for access to care

Fees with controlled overrun

€45.73

€21.01

Sector 2

Fees available

€45.73

€21.01

Who can help me?

Find who can answer your questions in your region