The terms and conditions for the reimbursement of physiotherapy services are defined by the agreement between the CNS and the Association luxembourgeoise des kinésithérapeutes (ALK), the nomenclature of acts and services of the masseurs-kinésithérapeutes and specific provisions of the CNS statutes. You will find direct links to these legal bases at the bottom of this page.
The conditions of reimbursement are explained in the space for insured persons (Physiotherapy) on our website. Providers will find below additional information on the procedure for validating prescriptions and on the operation of billing through the third party payment system.
Procedure for validation of prescriptions
To be eligible for reimbursement from the National Health Fund or the relevant public sector fund, all physiotherapy procedures must be prescribed by a doctor and the prescription must be validated by the CNS. Prior validation allows the provider to have confirmation that the costs of the treatment will be covered by the maternity health insurance before starting a treatment that extends over several sessions.
Application for validation by the insured person
If the insured person requests validation, they must send the original medical prescription by post to the CNS. The CNS will then send the insured person a reimbursement certificate or a reasoned refusal in paper form. If the request is approved, the patient can go to a physiotherapist and give him the prescription and the certificate of coverage.
In this case, direct payment by the CNS (third-party payment) is excluded.
Request for validation by the physiotherapist
The request for validation by the physiotherapist has several advantages over the request by the insured person, in particular because the exchange between the providers and the CNS is done electronically and thus allows a faster and more reliable transfer of data. At the same time, the electronic application and issuing of the claim form is a prerequisite for the application of the third-party payment system.
After scanning the prescription received by the insured person and entering the information on it using a suitable computer tool, the physiotherapist sends the scanned claim to the CNS and receives a return within one working day (except in special cases). The return is also sent electronically and takes the form either of a reasoned refusal or of an agreement completed by a reimbursement voucher number, an indication of the voucher's period of validity and details of the services validated.
Billing procedure
Advance payment by the insured person
At the end of the treatment, the physiotherapist presents the insured person with an invoice showing the total amount to be paid, i.e. the part to be paid by the health insurance company and the part to be paid by the insured person.
After payment, the insured person himself applies to his competent health insurance fund (CNS or public health insurance fund) for reimbursement of the part payable by the health insurance.
Application of the third-party payment system
The third-party payment system is not applicable when the insured person has applied for coverage to the CNS. In other cases, it must be applied by the provider if the insured person so requests and for benefits provided to persons protected under the jurisdiction of the Accident Insurance Association.
The part that is not reimbursed by the health insurance is billed directly by the physiotherapist to the insured.
In order to obtain the payment of the part of the fees opposable to the health insurance within the framework of the third party payment, the physiotherapist transmits his fee memoirs within the framework of the electronic data exchange to the CNS. The physiotherapist can include all the sessions provided without having to wait for the end of a serial treatment (several sessions prescribed by a prescription).
The procedures for drawing up and transmitting billing files to the CNS are set out in the specifications attached to the agreement between the CNS and the ALK and are explained in the "Electronic data exchange" section of this site.
After processing, the CNS transmits an electronic file containing all the information and reasons for the invoices that are not or not fully reimbursed and then proceeds to pay the amount due within 30 days.