Psychotherapy
I need to see a psychotherapist.
The need for psychotherapy should not be taboo. The proof - applying for reimbursement by the health insurance scheme is now possible.
However, the professionals must be recognised and the sessions must be prescribed by a doctor.
No unnecessary stress: here are the procedures to follow to ensure that money is not an obstacle to my health.
All I need to know
- Definitions to know
- Sessions covered
- Terms and conditions of coverage
- Limitations
- Reimbursement
What's the difference between psychologists, psychotherapists and psychiatrists?
It's not always easy to make sense of all the different professions in this sector.
In Luxembourg, the following definitions have been adopted.
- A psychologist is a professional with a university degree in psychology, typically at the master’s level, who works in various fields such as assessment, counseling, psychological support, research, or training.
- A psychiatrist is a doctor who has specialised in the field of psychiatry. Like any doctor, they can prescribe specific medicines or treatments.
- A psychotherapist is a psychologist or psychiatrist who has undergone further training in psychotherapy.
In a nutshell, the CNS :
- does NOT cover sessions with a psychologist
- covers sessions with a psychiatrist (see our ‘ Doctors ’ page)
- covers sessions with a psychotherapist (from 1 February 2023)
This page explains the coverage mentioned in point 3, i.e. coverage for sessions with a psychotherapist.
What sessions are covered?
Three types of session have been defined:
- Introductory psychotherapy sessions (SP01)
- Supportive psychotherapy sessions (SP02)
- Prolonged supportive psychotherapy (SP03)
The treatment is therefore structured according to a precise protocol with successive acts.
What are the terms and conditions for reimbursement?
Medical prescription
My sessions with a psychotherapist are only reimbursed on presentation of a medical prescription.
On this prescription, my doctor must certify that there are no medical contraindications to psychotherapy. The doctor must also certify that there is no somatic cause for the mental or behavioural disorder, and that psychotherapeutic treatment is appropriate.
SP01 - Prior or subsequent prescription
For introductory psychotherapy (SP01), I can begin treatment before my doctor issues a medical prescription.
In practical terms, this means that I can have between one and three SP01 sessions without having a prescription before the start of the session. Important: a medical prescription is then required for reimbursement and must be issued within 90 days of the first SP01 session for which I wish to be reimbursed.
SP02 and SP03 - Prior prescription only
For sessions of supportive psychotherapy (SP02) and extended supportive psychotherapy (SP03), however, a doctor's prescription must always be issued before my sessions begin.
Start of treatment
Unless otherwise advised by my doctor, my treatment must begin within 90 days of the date of issue of the prescription.
Cumulation of acts
Only one act in the nomenclature (SP01, SP02 or SP03) may be claimed per day.
What are the coverage limitations?
Time limits
The health insurance scheme has defined time criteria for covering (i.e. reimbursing) sessions:
- Every 5 years, up to 3 acts SP01 (introductory psychotherapy) and up to 24 acts SP02 (supportive psychotherapy) are covered.
- Every 10 years, up to 120 acts SP03 (extended supportive psychotherapy) are covered.
The 5-year or 10-year period begins on the issue date of the medical prescription which led to coverage of an introductory psychotherapy session (SP01).
Concrete example
My medical prescription for SP01 was issued on 15.05.2024, which marks the start of my treatment.
I am requesting reimbursement for my SP01 sessions, based on this prescription, which confirms that there are no contraindications.
At that point, the deadlines for limitations on reimbursement start to run.
I am therefore entitled to reimbursement for:
- Up to 3 SP01 acts for the period from 14.02.2024 to 14.05.2029 (5 years + 90 days before the date of the prescription). Explanation: The prescription for SP01 can be issued up to 90 days after the SP01 session. The 90 days prior to the date of the prescription are therefore taken into account: 15.05.2024 - 90 days = 14.02.2024.
- Up to 24 SP02 acts for the period from 15.05.2024 to 14.05.2029 (5 years).
- Up to 120 SP03 acts for the period from 15.05.2024 to 14.05.2034 (10 years).
The health insurance scheme has defined time criteria for covering (i.e. reimbursing) sessions:
- Every 5 years, up to 3 acts SP01 (introductory psychotherapy) and up to 24 acts SP02 (supportive psychotherapy) are covered.
- Every 10 years, up to 120 acts SP03 (extended supportive psychotherapy) are covered.
Limitation per prescription
Although doctors are generally aware of this restriction, to avoid any unpleasant surprises, I should know that the first medical prescription covers a maximum of 27 sessions:
- 3 sessions of introductory psychotherapy (SP01), and
- 24 sessions of supportive psychotherapy (SP02).
I then need a new medical prescription for each series of 24 extended support sessions (SP03).
How do I get reimbursed?
Upfront payment
Coverage for psychotherapy is in the form of reimbursement. I therefore have to pay the costs in advance and claim reimbursement from my health insurance fund.
When I have psychotherapy sessions, I must agree with the professional on a payment schedule (per session, per month, etc.). The psychotherapist will then give me one or more invoices showing the total amount to be paid, with the portion covered by health insurance and the portion to be paid by me.
Once I have paid, I apply for reimbursement from my relevant health insurance fund (CNS or public sector health insurance fund).
My request for reimbursement must include:
- The paid invoice(s) showing my surname, first name and 13-digit identification number.
- The original medical prescription, which I enclose when I send in the first invoice relating to this prescription.
What is the reimbursement rate?
Acts and services listed in the psychotherapists' nomenclature are reimbursed at a rate of:
- 70% for adults;
- 100% for insured persons under the age of 18 on the date the medical prescription is issued.
Frequently asked questions (FAQ)
Can I receive psychotherapy treatment/sessions abroad?
Yes, if the psychotherapist is established in a country of the European Union, Norway, Iceland, Liechtenstein or Switzerland. The conditions and rates of reimbursement are the same as if I were consulting a psychotherapist in Luxembourg.
I should read the 'All I need to know' section above in detail to find out more.
What about cross-border workers?
If I am a cross-border worker and I consult a service provider in my country of residence, it is the health insurance fund in my country of residence that is responsible for these reimbursements. I therefore contact my local fund directly.
Can I be reimbursed if the doctor who prescribed the psychotherapy sessions is based abroad?
Yes, the medical prescription can be issued by a doctor established in a country of the EU, Norway, Iceland, Liechtenstein or Switzerland.
Are teleconsultations covered?
No. Teleconsultations, whether in Luxembourg or abroad, are not covered. They are not included in the nomenclature for psychotherapists.
How are consultations with a doctor specialising in psychiatry covered?
They are covered in the same way as consultations with my GP or any other specialist doctor.
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