Digital Health CNS

From July 2025, digital transmission will be mandatory for doctors and dentists and will be introduced progressively.

In accordance with the new CNS-AMMD agreement, forms currently provided to patients in paper format – such as invoices, prescriptions, etc. – that are required for coverage by the CNS must be transmitted digitally.

The AMMD and the CNS have decided that digital transmission will be concentrated on fee invoices in 2025.

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

Everything you need to know

Step 1: Mandatory digital exchange of invoices

In accordance with the new CNS-AMMD agreement, which is set to come into force on 1 June 2025, forms currently provided to patients in paper format – such as invoices, prescriptions, etc. and necessary for coverage by the CNS, must be transmitted in digital form.

The AMMD and the CNS have decided that digital transmission will be concentrated on invoices in 2025.

Aware that the path to digital transition is not always easy and can raise many questions, the CNS and the AMMD have agreed to introduce a transitional phase until the end of 2025 so that the digital shift can take place progressively, giving software publishers the time they need to develop and test their digital solutions by doctors in the field in real time before becoming widespread. During this phase, doctors and dentists will be able to continue issuing paper invoices, as is currently the case.

Only then will digital transmission be gradually extended to other forms (certificates of incapacity for work, 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 provide you with the best possible support during this transition, we advise you to contact your current publisher or another publisher if you have not already done so. You can find a list of publishers who have already obtained certification by clicking here.

What does this mean for publishers?

The CNS, together with its partners, is currently setting up a technical environment which, from 1 June, should enable publishers to equip medical practices with new versions of their software that comply 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.

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

During a compliance and testing phase by all software publishers between 1 and 30 June, doctors can ask their software publishers to install a version of their software in their medical practices from 1 July that enables them to meet the future contractual obligation to transmit invoices digitally in the form of:

  • Immediate direct payment (PID), and/or
  • Digital reimbursement, currently still known as ‘accelerated reimbursement’.

This obligation to transmit invoices will not come into force for doctors and dentists until January 2026. It should also be noted that patients still have the right to obtain a printed version of the invoice for their own use, or must receive a ‘receipt’ as part of the PID.

Consequently, all doctors who wish to move forward with digitalisation should be able to transmit their invoices in digital form and offer the PID and/or digital reimbursement from 1 July 2025.

When will the digitalisation of other forms begin?

For other forms, the digital requirement under the CNS-AMMD agreement applies to XML file transfers and will only come into force three months after the publication of the XML files, which is scheduled for 1 October 2025 for CITs (certificates of incapacity for work) and 1 April 2026 for medical prescriptions.

Here too, implementation will take place during an initial phase on a voluntary basis and the roll-out will have to be sufficiently tested before being generalised. During this period, doctors and dentists will be able to continue issuing the forms mentioned above in paper form, as is currently the case.

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