Device usage fees
From 1 January 2025, new flat rates for the use of devices will be introduced in the nomenclature of medical acts and services, replacing the device fees marked with the letter X.
The CNS has provided me with information about the upcoming changes and the procedures to be followed, namely:
- how to declare devices
- how to bill flat rates
Click here to view the amendments in the Official Journal (Mémorial A No. 588 of 24 December 2024).
In a nutshell
From 1 January 2025, flat-rate fees for the use of medical devices will only be reimbursed for devices installed outside hospitals and declared to the National Health Fund by the doctor or association of doctors.
The medical disciplines and devices currently covered are as follows:
- Gynaecology-obstetrics: Ultrasound scanner, Cardiotocograph
- Hepatology-gastroenterology: Ultrasound scanner
- Otolaryngology: Ultrasound scanner, endoscope/fibroscope, audiometer, rhinomanometer, impedance meter/tympanometer, auditory evoked potential recording device, videonystagmograph
Doctors billing for acts falling under the following chapters of Part II, ‘Actes techniques’ of the nomenclature for doctors must declare their equipment:
- Chapter 1: ‘Médecine générale - Spécialités non chirurgicales », section 6 « Hépato-Gastro-Entérologie’
- Chapter 3: ‘Oto-Rhino-Laryngologie’
- Chapter 6: ‘Gynécologie’
In this context, doctors must complete a specific declaration and apply a new flat-rate billing for each device.
Consequence: Since 1 January 2025, doctors in the relevant disciplines can no longer bill acts completed with the letter X (Article 15 of the nomenclature).
Everything you need to know about the declaration
In order to charge flat rates for device usage, the aforementioned doctors must declare their device(s).
To declare a device, doctors must complete the relevant form:
- Declaration of a new device
- Declaration of a second-hand device
- Declaration of a device being taken out of service
- Principle of the declaration
- Declaration - New device
- Declaration – Second-hand equipment
- Declaration - Decommissioning
- Frequently asked questions (FAQ)
Why and how to make the declaration?
The doctor must complete one of the following declarations:
These declarations must be made immediately so that the CNS can assign a unique identification number to each device declared.
This identification number is essential for billing flat-rate fees for device usage.
When assigning a specific identification number to each device, the CNS will provide you with the following information:
- CNS identifier for your device (device identification number)
- Date on which the identifier began to be used
- Class of device - based on acquisition value
- Number of flat rates billable at full amount annually (reference activity threshold)
- Number of flat rates billable at full amount (over the entire amortisation period)
- Billable act codes: xx (full flat rates) and xx (reduced flat rates)
If a previously declared device is taken out of service, please complete the declaration below:
Declaration of a new device
As of the entry into force of the Grand Ducal Regulation on flat-rate fees for the use of devices, the following devices must be declared in order to obtain an identification number, whether for a new device or for a device already in the possession of doctors:
- Cardiotocograph
- Ultrasound scanner
- Audiometer
- Rhinomanometer
- Impedance meter/tympanometer
- Endoscope/fibroscope
- Auditory evoked potential
- Videonystagmograph
These devices must be registered in accordance with the regulations in force in order to receive a device identification number.
Documents to be sent to the CNS
- In the case of purchase: paid invoice
- In the case of leasing: signed leasing contract
- In the case of rental: signed rental agreement
- Signed delivery/receipt note with the device's full serial number.
Form
Déclaration d'un nouvel appareil
Please note: Documents must be sent in PDF format to gefo.cns@secu.lu. Requests in JPEG and HTML formats cannot be accepted.
Declaration of a second-hand device
From 2 January 2025, the following form must be used to declare any second-hand device, whether purchased in Luxembourg or abroad:
- Cardiotocograph
- Ultrasound scanner
- Audiometer
- Rhinomanometer
- Impedance meter/tympanometer
- Endoscope/fibroscope
- Auditory evoked response
- Videonystagmograph
These devices must be registered in accordance with the regulations in force in order to receive a device ID number.
Documents to be sent to the CNS
- Form in due and proper form
- Paid invoice
Form
Déclaration d'un appareil d'occasion
Please note: Documents must be sent in PDF format to gefo.cns@secu.lu. Requests in JPEG and HTM formats cannot be accepted.
Declaration of decommissioning of a device
This form must be used when a doctor stops using a device, whether due to its sale, disuse or because it is no longer in working order. The information will be sent to the CNS, enabling them to update their database. The device identification number will then be closed.
Form
Déclaration de mise hors service d'un appareil
Please note: Documents must be sent in PDF format to gefo.cns@secu.lu. Requests in JPEG and HTML formats cannot be accepted.
How should eligible devices already in place before 2025 be declared?
Eligible devices in place before 1 January 2025 must be declared using the ‘Declaration of a new device’ form.
How should eligible devices installed from 2025 onwards be declared?
Eligible devices installed on or after 1 January 2025 must be declared using the ‘Declaration of a new device’ or ‘Declaration of a second-hand device’ form.
Who can complete the declarations in question?
The declarations in question are completed either by the doctor or by the association.
If several doctors use the same device, does each doctor have to declare the device?
If a device is used by several doctors, only one doctor is responsible for registering the device and communicating its ID to the other users.
Please note: the reference activity threshold (maximum number of full-price annual flat-rate) is calculated per device, regardless of the number of doctors who use it.
What does the acquisition value of a device include?
For all devices purchased on or after 1 January 2025, the purchase price includes the price of the device and a maximum of five probes, if applicable.
Prices must be listed separately by category.
The following items are not included:
- Office furniture (chairs, tables, filing cabinets, etc.)
- IT equipment (monitors, keyboards, printers, etc.)
- Accessories (gels, scales, etc.).
What is a paid invoice?
A paid invoice is either an invoice stamped by the supplier as paid in full or an invoice accompanied by proof of payment, such as a debit advice confirming that the seller's account has been credited with the amount due.
Everything you need to know about invoicing
Coverage of fees for services rendered is provided as part of flat-rate device usage fees:
- either through immediate direct payment
- or through third-party payment
- Billing of flat rates
- Invoice and third-party payment statement
- Specifications by discipline
- Frequently asked questions (FAQ)
Billing of flat rates for device usage
Flat rates for device usage are billed either via immediate direct payment or via third-party payment.
Coverage via immediate direct payment (PID)
Coverage can be provided via the PID mode. In this case, both codes, that of the technical act (basic act) and that of the flat-rate fee for device usage, are indicated on the simulation of the same invoice.
Coverage via third-party payment
The doctor may also apply the third-party payment method. In this case, the doctor issues two separate invoices:
- the first, to be given to the patient, under the reimbursement method for the technical act (= basic act) that has just been performed
- the second to be sent to the CNS under the third-party payment scheme for the flat-rate fee for the use of the device
The invoice to be used under the third-party payment scheme and the third-party payment statement for flat-rate fees for the use of devices can be found under the tab ‘Invoice and third-party payment statement’.
Some details regarding the third-party payment system:
- Only the flat-rate fee for the use of devices is indicated on the invoice. The technical act (= basic act) is not indicated.
- Reimbursement by the health and maternity insurance fund is made at 100% of the official rate listed in the nomenclature of medical acts and services.
- The invoices in question are submitted to the CNS in bulk once a month, accompanied by a single separate statement.
- A specific statement is drawn up in this context - not to be confused with the ‘Article 60’ statement (third-party payment) or the ‘Article 67’ statement (direct action).
Templates for invoices and third-party payment statements
The following invoice template should be used for third-party payments:
This invoice must be submitted to the CNS together with the third-party payment statement for flat-rate fees for the use of devices:
Specifications by medical discipline
By clicking on a link below, you can view the:
What do the flat rates include?
These packages include the depreciation costs and operating costs of the installed device, including the main equipment, corrective and upgrade maintenance, consumables and costs related to archiving the results delivered by the device.
What justifies the variation in the amount of the flat rate in question?
The flat rate for device usage costs varies depending on the class to which the installed device belongs, the date of the first service resulting from the use of the installed device and covered by health insurance, the number of acts performed and a reference activity threshold.
Is the flat rate for device usage linked to the technical act (or basic act)?
Yes. The billing of a flat rate for device usage is conditional upon the billing of the technical act (= basic act).
How are existing devices handled?
What should I do if I have reached the activity threshold (maximum number of full-price annual flat rates)?
You must invoice the reduced flat rate for the rest of the year.
If several doctors use the same device, can each of them deduct the maximum flat-rate amount?
The reference activity threshold (maximum number of full-year flat-rate fees) applies to each device, regardless of the number of doctors who use it.
Thus, a device shared by several doctors has the same ceiling as if it were used by a single doctor.
Who should I contact if I have any questions?
If I have any questions about billing for device usage fees, I will use the dedicated contact form.
Contact us
For editors
These files do not contain any comments assigned to a chapter, section, subsection or tariff code.
These files are for consultation and work purposes only. They do not replace the official publications in the Official Journal of the Grand Duchy of Luxembourg, which are the only authoritative documents.
Memorial
The amendments were published in the Official Journal on 24 December 2024.
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