The CNS covers nursing care at the provided rates and tariffs, as long as a doctor has prescribed them. The insured person is free to choose any nurse, whether they work independently or for a care and assistance network.
Services and medical prescriptions
Services by nurses
Nurses can invoice all acts and services listed in the table of the nomenclature of acts and services provided by nurses.
Nurses do not have the right to invoice acts and services from their nomenclature if they provide care for people who are entitled to palliative care.
Furthermore, nurses can perform the acts BY001 (blood sample from a superficial vein) and BY002 (blood sample by venipuncture on a child under the age of 6) from the nomenclature of acts and services provided by laboratories.
Nurses can only invoice acts in relation to injections or infusions when the administrated drugs are covered by health insurance or when a vaccine is injected.
Acts that are performed in the following settings cannot be invoiced:
- in hospitals and specialised hospital establishments;
- in establishments for convalescence cures;
- in medical practices.
Medical prescriptions for nursing care
All acts and services provided by nurses must be prescribed by a doctor on a medical prescription. However, a medical prescription is not required for the daily rates provided within the framework of the long-term care insurance (acts N801, N802, N803 and N804).
Venous blood collection performed at home can only be charged if the medical necessity to perform the blood collection at the insured person’s home is certified on the medical prescription by the prescribing doctor.
If the medical prescription for nursing care does not indicate a period within which the treatment should begin, the treatment must start within 30 days of the date the prescription was issued.
If the nurse did not perform all services prescribed, they must indicate on the prescription the number of acts actually carried out.
Compensation for lost fees
If the insured person failed to keep an appointment or was away from home at the time they were supposed to receive the treatment, and if the insured person failed to notify the therapist at least during the day before the appointment, the nurse is entitled to a compensation for lost fees.
This compensation, as well as potential travel costs incurred, are not covered by health insurance.
Travel costs
For each home treatment, the nurse can charge a flat rate for travel expenses. If the nurse performs several treatments on the insured person during the same session, one single flat rate for travel expenses can be charged.
The flat rate for travel expenses is covered, provided that:
- the doctor specifies on the prescription that it is medically necessary for the treatment to be provided at the insured person’s home;
- the journey takes place inside Luxembourg. Journeys beyond the border are not covered.
The nurse is not allowed to charge a flat rate for travel expenses for treatments provided:
- in facilities for care and assistance in accordance with article 390 of the Social Security Code;
- in hospitals and specialised hospital establishments;
- in establishments for convalescence and therapeutic cures;
- in medical practices.
If these conditions are met, the flat rate is covered at the same rate as the nursing treatment provided at home.
Nursing care abroad
When it comes to nursing care delivered in the country of residence of a cross-border worker, these services are exclusively reimbursed by the local health fund of the country of residence, in accordance with the rates, tariffs and conditions of that country.
The insured person must contact a registered nurse in the country of residence.
Coverage of costs
Method of payment
Payment method
The third-party payment system
Usually, nursing care is covered directly by health insurance through the third-party payment system.
As part of the third-party payment system, the insured person pays the nurse only the proportion payable by them.
The third-party payment system only applies to nursing care provided in the Grand Duchy. Nursing care delivered abroad must always be paid for in full, and the proportion covered by the health insurance fund is then reimbursed upon request. Please note that for cross-border workers, the local health fund is responsible for covering healthcare received in their country of residence and the treatment must be provided by a nurse registered in that country.
The insured person pays the full amount of the treatment and requests a refund
If the insured person receives an invoice, they must pay the costs upfront and send the original, paid and receipted invoice to the competent fund (CNS or public sector fund) along with the original medical prescription. The nurse returns the original prescription to the insured person along with the invoice.
Coverage rate
Coverage rate
Acts and services from the nurses' nomenclature are covered at a rate of eighty eight percent (88%) of the fixed tariffs.
However, coverage rate is hundred percent (100%) for acts provided by nurses for:
- insured persons under the age of eighteen (18) at the time the medical prescription was issued;
- insured persons who have a care plan, namely persons entitled to services from the long-term care insurance or receiving either a care allowance or a special allowance for persons with severe disabilities.