The value of the key letter and rates
The National Health Fund (CNS) and the Luxembourg Association of Physiotherapists (ALK) have reached an agreement as part of the mediation procedure relating to the revaluation of the key letter value applicable to physiotherapy acts and services.
Following the failure to reach an agreement during the collective bargaining negotiations, both parties resorted to the mediation procedure provided for in the Social Security Code. The ensuing discussions took place in a constructive, calm and responsible spirit, with the CNS and the ALK demonstrating a shared willingness to reach a balanced compromise.
Taking into account the catch-up factor for the period from 1 January 2026 to 31 December 2026 to compensate for the delayed implementation of the adjustment, the value of the key letter is 45.2941 on 1 January 2026 (index 968.04).
The rates for acts and services can be consulted in the version coordinated on 1 January 2026 of the nomenclature of acts and services provided by physiotherapists.
Memorial A No. 637 of 24 December 2025 - Memorandum of understanding
List of acts and services provided by physiotherapists - Version coordinated on 1 January 2026
The agreement and specifications
The ALK and the CNS have given their authorisation to adjustments to the agreement and specifications from 1 January 2026:
- The reimbursement of IT costs in the form of an annual lump sum will no longer exist from January 2026. From 2026, the new value of the key letter has been negotiated taking IT costs into account.
Applications for the annual IT allowance for the 2025 financial year can be submitted to the CNS until 31 March 2026 at the latest.
- The maximum number of services has been set at two sessions per hour and 24 sessions per day.
Memorial A No. 635 of 24 December 2025 - Agreement
Memorial A No. 636 of 24 December 2025 - Specifications
Agreement between the ALK and the CNS - Coordinated version as of 1 January 2026
Specifications of the agreement - Version coordinated on 01.01.2026
The invoice number and XML files
From 1 April 2026, a new invoice number must be indicated in the XML files when a personal contribution from the insured person is due: this is the number of the invoice issued to the patient.
This is not the invoice number used in the context of third-party payment for the physiotherapist's invoicing to the CNS, which remains unchanged and already exists.
XSD file - Invoicing (XSD)
Explanations - Invoicing (Word)
XSD file - Invoicing return (XSD)
Explanations - Invoicing return (Word)
