#SFHU2609208SDecision of 11 March 2026 of the National Union of Health Insurance Funds on the List of Acts and Benefits Covered by Health Insurance
AI-generated summary for informational purposes only. Not legal advice. See the original source for the authoritative text.
This French health insurance decision updates reimbursement rules for psychiatric consultations and physiotherapy/rehabilitation services. It introduces faster-access psychiatric consultations: within 4 working days when requested by a general practitioner, emergency doctor or SAMU regulator, or within 2 working days when requested by the Service d'Accès aux Soins (SAS) regulator. These must use the MCY or TC2 coding and cannot be combined with on-call duty surcharges. The decision also revises coefficients for complex rehabilitation sessions involving multiple body areas or post-amputation care, effective 28 May 2026. It further expands eligibility for the specific travel indemnity (IFS) to masseurs-physiotherapists and extends the timeframe for certain post-hospitalization orthopedic rehabilitation sessions up to 35 days after discharge.
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Key Changes
- Psychiatric consultation (MCY/TC2) reimbursable within 4 working days if requested by treating physician, emergency doctor or Centre 15 regulator
- Psychiatric consultation reimbursable within 2 working days if requested by SAS (Service d'Accès aux Soins) regulator
- Psychiatric consultation cannot be combined with permanence des soins surcharges (article 22-3)
+ 4 more changes with Pro
Obligations
What this law requires
Psychiatrists must complete fast-access consultations within 4 working days when requested by a general practitioner, emergency doctor, or SAMU (Centre 15) regulator
Psychiatrists must complete fast-access consultations within 2 working days when requested by a Service d'Accès aux Soins (SAS) regulator
Fast-access psychiatric consultations must be coded using MCY (or TC2 for teleconsultations) and cannot be billed in combination with on-call duty surcharges (permanence des soins)
Apply revised coefficient 9.79 (TER) for rehabilitation of lesions in at least 2 territories without surgery, and 9.81 (TER) with surgery on at least one territory, effective 28 May 2026
Apply revised coefficients for post-amputation rehabilitation: 8.11 (APM) for upper limb amputation, 8.10 (APM) for lower limb amputation, and 9.80 (APM) for at least 2 members amputation, effective 28 May 2026