#SFHU2608908SDecision of 3 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 2026 decision updates the French nomenclature of medical biology acts reimbursed by social security. It removes three pre-analytical sampling codes (9058, 9059, 9060) and introduces specific billing rules for patients presenting with only COVID or HPV/cervical cancer screening prescriptions. Laboratories may now bill a dedicated forfait (9010 for HPV or 9011 for COVID) when no other pre-analytical package has been charged that day. When other acts are also prescribed, only the standard 9005 pre-analytical package may be billed if not already charged. Additionally, the hematology-cytology act 1124 is deleted from the nomenclature. The decision takes effect 14 days after publication in the Official Journal.
AI-generated summary. May contain errors. Refer to official sources for legal decisions.
Key Changes
- Removal of pre-analytical sampling codes 9058, 9059 and 9060 from the general provisions
- Introduction of new billing paragraph allowing forfait 9010 (HPV) or 9011 (COVID) when patient presents only with COVID or HPV screening prescription and no other pre-analytical forfait billed that day
- Requirement to bill only standard pre-analytical forfait 9005 when COVID/HPV acts are combined with other acts (if 9005 not already billed that day by any laboratory)
+ 2 more changes with Pro
Obligations
What this law requires
Remove sampling codes 9058, 9059, and 9060 from the medical biology nomenclature effective 14 days after Official Journal publication
When a patient presents with only a COVID prescription and no other pre-analytical package has been billed that day (regardless of laboratory), bill the dedicated forfait 9011 for COVID
When a patient presents with only an HPV/cervical cancer screening prescription and no other pre-analytical package has been billed that day (regardless of laboratory), bill the dedicated forfait 9010 for HPV
When a patient presents with COVID or HPV prescriptions combined with other acts, bill only the standard pre-analytical package 9005 if it has not already been billed that day (regardless of laboratory)
Delete hematology-cytology act 1124 from the nomenclature under chapter 5, sub-chapter 01 (HEMATOLOGIE - CYTOLOGIE CHIMIE DIVERS)