Billing for doctors and dentists

Invoices relating to reimbursement and the PID are submitted electronically, in accordance with the applicable technical standards.

Since 31 October 2026, the framework governing invoicing procedures has changed. For certain services, the invoicing method is no longer predetermined as it was previously. Depending on the applicable rules, different methods may be used.

This page outlines the various invoicing methods and guides you towards the available solutions.

In a nutshell

  • Digital submission of invoices applies to Reimbursement and Immediate Direct Payment (PID). Several billing methods are possible, depending on the applicable rules.
  • Immediate Direct Payment (PID) allows for direct coverage: the patient does not have to pay the amount covered by  health insurance up front. The invoice is processed individually, with checks carried out at the time of submission and prompt payment to the doctor.
  • The other methods are reimbursement, with upfront payment by the patient, and third-party payment.

Billing Methods

Depending on the method used, the patient may either make an upfront payment and then claim a refund, or have coverage for the amount covered by health insurance provided directly.

The three methods are set out below, along with their main features.

PID – Direct coverage via individual submission

With Immediate Direct Payment (PID), the invoice is submitted individually to the CNS. The amount covered by health insurance is paid directly to the doctor. The patient therefore does not have to pay it up front.

PID allows the necessary details for coverage to be verified at the time of submission. Payment is made instantly.

The benefits of PID at a glance:

  • Prompt payment: the portion covered by health insurance is paid directly to the doctor.
  • Checks carried out at the time of transmission, in particular regarding the patient’s affiliation status and acts billed. These checks ensure, via the rules engine, that billing complies with the applicable coverage rules.
  • No upfront payment required for patients: the portion covered by health insurance is paid directly to the doctor. The patient therefore does not have to make an upfront payment or wait for a refund.
  • Simplified administrative management

Full details on how it works and how to use it are available on the dedicated page.

Find out more about Immediate Direct Payment

Reimbursement

Under the reimbursement system, the patient pays the doctor’s fees and then requests a reimbursement from their health insurance fund.

With Digital Reimbursement, the data from the invoice is transmitted digitally. The patient continues with an upfront payment and then submits their claim for reimbursement to their health insurance fund. Patients can submit their reimbursement claim online via MyGuichet.lu or the GesondheetsApp, without having to send their invoice by post.

Points for doctors to bear in mind:

  • payment of fees is made by the patient, with a risk of delayed payment or non-payment for doctors and dentists;
  • Unlike the PID, this type of invoicing does not benefit from the PID’s rule engine checks. The compliance of invoices is therefore not automatically verified upon submission.
  • Any invoicing errors can therefore only be detected at a later stage.

Detailed information on how the system works and the procedures to follow is available on the dedicated page.

Learn more about Digital Reimbursement

Third-party payment – Direct coverage via bulk transmission

Under the direct coverage via bulk transmission scheme, the portion covered by health insurance is paid directly to the doctor. The patient therefore does not have to pay this amount up front.

Several invoices are grouped together and submitted to the CNS with a summary statement.

Points for the doctor to note:

  • invoices are grouped together, rather than processed individually as with the PID;
  • bulk submission may be carried out a maximum of once a month;
  • the amount of coverage actually provided is known once it has been processed by the CNS;
  • the amount remaining to be paid by the patient can therefore, where applicable, be determined and invoiced at a later date;
  • payment is made at a later date, in accordance with the applicable deadlines.

Practical details of third-party payment

Please find below detailed information regarding the conditions for third-party payment, the summary statement and the rules governing its submission to the CNS.

Terms and conditions governing the direct payment scheme

1. Conditions applicable to direct coverage

Services for which insured persons have not made any upfront payment.

Bulk submission of invoices to the CNS.

2. The summary statement

A single summary statement accompanies the invoices.

In accordance with Article 13 of the Grand-Ducal Regulations laying down the mandatory provisions governing relations between health insurance and doctors and dentists, respectively, the summary statement contains the following information:

  • the reference number of each invoice,
  • the identification number of each insured person,
  • the total amount of each invoice,
  • the total amount of fees claimed.

Disputed fees may be included in a subsequent summary statement from the doctor once the grounds for the dispute have ceased.

3. Coverage

Direct payment by health insurance to the healthcare provider for the portion of the fees covered by the scheme (excluding the insured person’s contribution).

The coverage rate is defined by Articles 35 and 35bis of the CNS statutes.

4. Determining the month to which a summary statement relates

The postmark shall serve as proof for determining the month to which a summary statement relates.

Where a doctor returns to the CNS a summary statement that has been returned to them in full for correction, the postmark on the new dispatch shall be taken as proof.

In the absence of a postmark, the first official stamp affixed to the summary statement submitted for a second time, or even to the envelope, shall be taken as proof. This may, in this case, be the stamp of the CNS Mail Service, the stamp of another CNS department or that of any other public institution of the Grand Duchy of Luxembourg.

Frequently asked questions (FAQ)

Are there any exceptions to the principle of digital transmission of data and information?

Yes!

For the ‘Reimbursement’ coverage scheme, there are two types of exemption:

  • By way of derogation from Article 5, paragraph 2, and per calendar year, a doctor or dentist is authorised to issue up to two hundred (200) standardised forms, which are valid for the health and maternity insurance scheme, in paper form and without transmission via a digital procedure to the national electronic platform for the exchange and sharing of health data.
  • By way of derogation from Article 5, paragraph 2, a doctor or dentist is authorised to issue standardised forms, which are valid for the purposes of health-maternity insurance, in paper form and without digital transmission to the national electronic platform for the exchange and sharing of health data, in the event of the platform being unavailable or in the event of technical force majeure beyond the control of the doctor or dentist.

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