#SFHS2611510AFrance approves new pay and practice rules for self-employed nurses
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This measure updates the national agreement between self-employed nurses and France’s health insurance system. It raises key nursing tariffs in stages, creates new paid nursing consultations, expands direct access for some wound care, and sets new billing rules for surveillance, medication support, diabetes care for schoolchildren, non-scheduled care, and dependent patients. Self-employed nurses, health insurers, patients with chronic conditions, schools, doctors, and care coordinators will be affected. Most operational changes phase in between 2027 and 2029, with several major payment and billing changes starting in 2028, so nursing practices and billing systems will need to prepare ahead of time.
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Key Changes
- Raises AMI and AMX nursing tariff values in two stages, reaching €3.45 from 1 November 2027.
- Creates paid nursing consultations, including insulin initiation support for type 2 diabetes patients and follow-up after the Mon Bilan Prévention health check.
- Introduces new surveillance, wound care, school diabetes care, non-scheduled care, and dependency-care billing rules, with many measures starting in 2027 or 2028.
Obligations
What this law requires
Self-employed nurses must bill insulin-initiation nursing consultations for type 2 diabetes patients only within the first six months after initial insulin treatment begins, with a maximum of four consultations per patient; the CIA consultation is not combinable with other acts, is not billable for patients covered by a nursing care forfait, and only travel expenses may be billed with it.
Self-employed nurses must bill post-'Mon Bilan Prévention' follow-up nursing consultations only within six months after the prevention assessment, with a maximum of four consultations per patient and per assessment; the CIB consultation is not combinable with other acts, is not billable for patients covered by a nursing care forfait, and only travel expenses may be billed with it.
Nursing consultations must be performed in a dedicated session without performing another technical act or dependency-care act in the same session; any other acts must be performed at another time of the day.
For weekly global clinical and therapeutic surveillance, nurses must create and update a surveillance sheet at each visit, may bill the AMI 3.77 act no more than once per week per patient, must include medication administration within the act, and must not bill it for patients covered by a nursing care forfait.
For acute clinical and therapeutic surveillance, nurses must create and update a surveillance sheet at each visit, may use the act only for acute illness or acute decompensation of chronic illness, may not bill it solely for medication surveillance, may bill no more than 15 visits over three months per patient, and must not bill it for patients covered by a nursing care forfait.