Digitalisation

Since July 2025, digital transmission for doctors and dentists has been gradually coming into effect.

In accordance with the new CNS-AMMD agreement, forms currently given to patients in paper format – such as invoices, certificates of incapacity for work, etc. – and required for coverage by the CNS, will soon have to be transmitted digitally.

On this page, you will find all the essential information you need to know about the future digital transmission requirement.

To find out more about Immediate Direct Payment (PID) or Digital Reimbursement, click on the section of your choice.

A section dedicated to electronic certificates of incapacity for work (eCIT) will be available soon.

Everything you need to know

Digital exchange of invoices and certificates of incapacity for work

In accordance with the new CNS-AMMD agreement, which came into force on 1 June 2025, the forms currently given to patients in paper format - such as invoices, certificates of incapacity for work, etc. and required for coverage by the CNS, must be submitted in digital form.

The AMMD and the CNS have decided that the first two forms to be exchanged digitally will be the invoice and the certificate of incapacity for work.

Aware that the path to digital transition is not always straightforward and can raise many questions, the CNS and the AMMD have agreed to implement a transitional phase until further notice so that the digital shift can take place in a progressive manner, giving software publishers the time they need to develop and test their digital solutions by doctors in the field in real time before they are rolled out across the board. During this phase, doctors and dentists will be able to continue to issue invoices and certificates of incapacity for work on paper, as is currently the case.

Only then will digital transmission be progressively extended to other forms (prescriptions, quotations, etc.) in 2026 and 2027.

This adaptation period is intended to finalise the software, optimise digital transmission and give doctors and dentists time to integrate these solutions into their practice.

To best support you in this transition, our agent recommends that you contact your current publisher or another if you have not already done so. You can find a list of publishers who have already obtained their certification by clicking here.

What does this mean for publishers?

The CNS, together with its partners, is setting up a technical environment that allows publishers to equip medical practices with new versions of their software that are compatible with digital transmission.

Three points are important to note regarding publishers:

  • The CNS is offering publishers an eConnector (an upgrade of the DHN solution) to install on their software, which should enable them to prepare their software for digital exchange and the PID. This eConnector NG will also enable forms to be time-stamped and signed electronically.
  • Another feature that will be added to the eConnector from October 2025 is the production of PDF versions of forms. From this date, publishers will no longer need to configure the forms in their software, but can simply load them via the eConnector.
  • The CNS has allocated a budget to contribute financially to the costs incurred by software publishers to install the new version of their software in medical practices.
More information on the Agency eSanté website

What does this mean in practical terms for doctors and dentists?

1. Invoice

Since July 2025, doctors and dentists have been able to ask their software publishers to install a version of their software in their medical practices that enables them to comply with the future contractual obligation to transmit invoices digitally, in the form of:

  • Immediate Direct Payment (PID), and/or
  • Digitalised reimbursement, currently still known as 'accelerated reimbursement'.

The obligation to transmit invoices will not come into force for doctors and dentists until 2026. The exact date has yet to be determined. It should also be noted that patients still have the right to obtain a printed version of the invoice for their own purposes.

2. Certificates of incapacity for work (eCIT)

The technical specifications will be made available to software publishers from October 2025. During a compliance and testing phase by all publishers, doctors will soon be able to ask their publishers to install a version of their software compatible with eCIT in their medical practices.

The obligation to transmit certificates of incapacity for work will not come into force for doctors and dentists until 2026. The exact date has yet to be determined. It should also be noted that patients still have the right to obtain a printed version of the certificate of incapacity for work for their own needs.

Can I be exempted from the digital obligation?

Doctors and dentists can be exempted from the digital transmission obligation, if they are born before 1 January 1965 and if they meet all of the following conditions:

  • they do not work within a medical or dental association as provided for in Article 3 of the agreement, and
  • their annual turnover is less than one hundred thousand euros (€100,000.00).

Those concerned who wish to obtain this exemption must submit a request for exemption to the CNS.

Doctors who benefit from this exemption may nevertheless opt for digital transmission, without this terminating their exemption.

How do I activate MySecu.lu web services?

Your software publisher has updated your software to enable the PID to function.

You must also activate the web services on mySecu.lu (this only needs to be done once). Activation is a simple process involving just a few steps. Once completed, you will be able to access and use the PID.

Here is a quick tutorial (in French only). I click on the 'enlarge' icon at the bottom left, or I click on this link to open the presentation in a new tab in my browser.

The major milestones of digitalisation

Here is a timeline of the first two major stages of digitisation, namely ‘digital reimbursement and the PID’ and ‘eCIT’.

Note: You can continue to use the old versions of other documents or forms provided for in the agreement, such as third-party payment and social third-party payment invoices, prescriptions, quotes, etc. Exception: FFUA invoices (flat-rate fee for use of equipment), for which the new template provided by the new agreement must be used.

We will keep you regularly informed of developments in the future stages of digitisation. Don't forget to subscribe to our CNS update newsletter.

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