Speech therapists
My child or I need speech therapy sessions!
If my child or I have speech, voice, or language difficulties, sessions with a speech and language therapist are particularly important. They help us improve our speech and communication with those around us, which is essential for our well-being and development.
Speech and language therapy services are covered by health insurance when prescribed by a doctor.
Everything I need to know
- Services of speech therapists and conditions
- Travel expenses
- Coverage
What acts and services are covered?
Speech therapists are healthcare professionals who help people of all ages with speech, language, communication, learning and swallowing difficulties in order to promote their independence, education, professional life, well-being and integration.
The full list of speech therapists' acts and services covered is set out in the nomenclature of speech therapist. I click here to view this nomenclature (list in PDF format).
What are the conditions for coverage?
A medical prescription
For my treatment, or that of my child, with a speech therapist to be covered, it must be prescribed by my doctor with a medical prescription. This must include information related to the medical diagnosis, the onset of the condition, as well as the code or wording of the nomenclature corresponding to the prescribed acts. In addition, the prescription must specify the exact number of sessions.
The nomenclature stipulates a maximum number of sessions for certain acts of speech therapists that are eligible for coverage. The minimum duration of an individual session is set at 30 minutes (not including preparation time).
In the case of group speech therapy, the minimum duration is 60 minutes for 2 patients and 75 minutes for 3 patients. BUT the speech therapist invoices each patient individually without a reduction.
Please note: foreign doctors' prescriptions must contain all the mandatory information and be written in French, German or English. Prescriptions written in any other language will be returned, as they cannot be processed by the CNS services.
The patient's age
For certain acts, an age limit or range is stipulated. In this case, this age limit or range is clearly specified in the description of the act.
Validation with a certificate of coverage
My prior medical prescription must be validated by the CNS. If the validation is accepted, the CNS sends a certificate of coverage to my speech therapist if they have requested it, or directly to me if I have requested it. This document specifies the number of sessions and the rate of coverage.
Please note: Treatment must begin within six months of the prescription being issued.
Best practice: I give the prescription to my speech therapist in Luxembourg during my first session. My speech therapist then takes care of validation with the CNS. If everything is in order, the CNS validates the prescription.
The validation request must be made within 30 days of the prescription being issued.
Prior authorisation from the Social Security Medical Inspectorate
In addition to validation of the prescription by the CNS, certain acts and speech therapy services require prior authorisation from the Social Security Medical Inspectorate (CMSS). If such authorisation is necessary, the CNS forwards the authorisation request directly to the CMSS.
Is there coverage for travel expenses?
Travel expenses include travel allowance and travel expenses per kilometre. For coverage of my speech therapist's travel expenses, certain conditions must be met:
- My doctor must specify on the medical prescription that it is medically necessary for the speech therapist to travel to my home to provide care.
- The journey must take place on Luxembourg territory. Any travel beyond the border will not be covered.
Please note: Travel expenses per kilometre can only be taken into account for travel outside the locality where the speech therapist has their practice and within that locality, if the journey exceeds one kilometre. However, the travel expenses charged may not exceed the expenses corresponding to the distance actually travelled.
If these conditions are met, travel expenses are covered at the same rate as that applied to the act performed during the trip.
How does coverage work?
Third-party payment
As a general rule, or at my express request, my speech therapist's fees are paid directly by the CNS under the third-party payment system.
Under the third-party payment system, I only pay the speech therapist the portion that I am responsible for.
The third-party payment system also applies if:
- the acts are delivered to the insured person within the framework of the competence of the Accident Insurance Association (AAA),
- the acts are delivered within the framework of inpatient treatment in a hospital, or
- travel allowances and travel expenses per kilometre are incurred.
Upfront payment
However, if the third-party payer has not been applied, my speech therapist will give me an invoice specifying the total amount to be paid, i.e. the part to be covered by health insurance and any part to be paid by me.
I am then required to advance the sum and send my request for reimbursement to my competent fund. The invoice must:
- include my (or my child's) identification number, full name and the number of the certificate of coverage;
- be validly paid;
- be accompanied by the certificate of coverage.
Coverage rate
The reimbursement rate for acts and services provided by speech therapists is 88%.
However, this coverage rises to 100% for all speech therapy acts carried out on my children if they have not yet reached the age of 18.
Frequently asked questions (FAQ)
And if I am a cross-border worker, what about coverage for speech therapy?
If I am a cross-border worker and my children or I receive speech therapy in my country of residence, the services will be reimbursed exclusively by my local fund, in accordance with the rates, tariffs and conditions in force in that country.
What are the codes and tariffs applied?
The full list of speech therapist acts and services covered is set out in the nomenclature of speech therapists' acts and services. I click here to view this nomenclature (list in PDF format).
Why did my speech therapist invoice me for fees lost or extraordinary constraints?
Compensation for loss of fees
If I fail to attend an agreed appointment or am not at home to receive care at the appointed time, without having notified my speech terapist at least the day before the appointment, they are entitled to compensation for loss of fees. This compensation, as well as any travel expenses, will not be covered by health insurance. These costs will therefore be at my expense.
Compensation for extraordinary constraints
If my speech terapist gives me an appointment at my express request on a specific day after 19:00 or on a Saturday, Sunday or public holiday, they are entitled to compensation for extraordinary constraints, provided that the appointment is outside my speech terapist's normal working days or hours and that they keep the appointment. This compensation is not refunded and will therefore be at my own expense.
No compensation may be claimed for services provided in an emergency. The same applies when the services are essential at the agreed times and dates due to the state of health of the insured person.
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