Physiotherapy

In order to be entitled to coverage from the CNS or the competent public sector fund, all physiotherapy-massage sessions must be prescribed by a doctor.

Validation procedure

Medical prescription: Content and number of sessions

A standardised prescription for physiotherapy must be issued, which provides information about the type of treatment, the number of sessions and their frequency as well as the treatment prescribed.

The number of sessions covered per prescription may vary depending on the type of treatment, that is 8 in case of a common pathology, 64 in case of a severe pathology and 32 in case of post-surgery rehabilitation.

Severe pathologies are defined in the statutes of the CNS and they are indicated on the back of the standardised prescription. All pathologies that are not on this list, except post-surgery rehabilitation, are considered to be common pathologies.

Foreign prescriptions must contain the same indications as the standardised prescription and they must be written in French, German or English. Prescriptions in other languages are returned, as they cannot be processed by the CNS.

Validation of the prescription

The prescription has to be validated by the CNS. In general, the insured person gives the prescription to the physiotherapist during their first session, who will then take care of the necessary administrative formalities. If the administrative conditions are met, the CNS validates the prescription. This validation has to be requested within 31 days of the issue date of the medical prescription.

Certificate of coverage

The validation takes the form of a certificate of coverage issued by the CNS.

The certificate of coverage states the maximum duration of the treatment, the number of sessions covered and the rate of coverage.

Session Proceedings

The physiotherapist can adapt the frequency of sessions and techniques used (massage, electrotherapy, …) according to the patient’s needs and the evolution of their pathology.

The physiotherapist has to respect certain quality standards. These standards provide, for example, criteria relating the treatment itself (it is not allowed to treat more than one patient at a time, definition of the content of the patient’s files, minimum duration of 20 minutes per session, …).

Travel costs

The physiotherapist's travel costs may be covered at a fixed rate, as long as:

  • the doctor indicates on the prescription that it is medically necessary for the physiotherapist to provide the treatment at the insured person’s home.
  • the journey takes place inside Luxembourg. Journeys beyond the border are not covered.

If these conditions are fulfilled, the fixed travel allowance is covered at the same rate as the physiotherapy treatment provided at home.

 

Coverage of costs

Method of payment

Third-party payment system

In this case, the insured person pays the physiotherapist only the portion payable by them and the physiotherapist sends an invoice to the CNS at the end of the treatment to receive the part of the costs covered by health insurance. The physiotherapist hands back the prescription to the insured person and issues a fee note which clearly indicates the portion payable by the insured person and the one payable by the CNS.

The third-party payment system only applies if the request for validation is done directly by the physiotherapist and the physiotherapy treatments are provided in the Grand Duchy. When the request for validation comes from the insured person or the physiotherapy treatments are provided outside the Grand Duchy of Luxembourg, the insured person has to pay the costs upfront. The portion covered by the health insurance 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.

Advance of costs by the insured person

In this case, the physiotherapist gives the insured person an invoice for the total amount to be paid at the end of the treatment, i.e. the portion covered by the fund and any remaining portion payable by insured. After payment, the insured person applies for a reimbursement of the portion covered by health insurance with their competent fund (the CNS or the public sector health fund)

To be eligible for a refund, the physiotherapy invoice must:

  • indicate the 13-digit identification number, the insured's full name and the number of the certificate of coverage,
  • be paid in full,
  • be submitted with the medical prescription.
Coverage rate

Coverage rate

The rate at which costs are covered is 70% for common pathology treatments.

Treatments for severe pathologies or a post-surgery rehabilitation, as well as treatments for children under the age of 18, are fully covered.

Note that some supplements that may be invoiced under the physiotherapist’s convention are not covered (such as charges for cancelled appointments).

 

Last update