{"id":662349,"date":"2025-12-30T11:27:10","date_gmt":"2025-12-30T11:27:10","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/662349\/"},"modified":"2025-12-30T11:27:10","modified_gmt":"2025-12-30T11:27:10","slug":"what-you-need-to-know-13","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/662349\/","title":{"rendered":"What you need to know"},"content":{"rendered":"<p>    We look at specialists affected and how reimbursement for patients will work for new tariffs<\/p>\n<p>\n        The changes in rates apply to sector 1 and some sector 2 doctors<br \/>\n        New Africa\/Shutterstock\n    <\/p>\n<p>New tariffs for certain specialist medical appointments are to come into force in France from January 1, 2026.\u00a0<\/p>\n<p>Appointments with pediatricians, gynaecologists, and geriatricians are among those affected with fees rising by \u20ac5 in several instances.<\/p>\n<p>The changes apply only to sector 1 (all doctors in this sector) and sector 2 professionals under the OPTAM scheme, <a href=\"https:\/\/www.connexionfrance.com\/practical\/how-french-doctor-sectors-impact-what-patients-pay\/724076\" target=\"_blank\" rel=\"noopener\">whose rates are controlled by Assurance Maladie<\/a>.\u00a0<\/p>\n<p>Other specialists (sector 2 doctors who have not signed the OPTAM scheme, and sector 3 doctors) will continue to set their own rates.<\/p>\n<p>In addition, a new <a href=\"https:\/\/www.connexionfrance.com\/news\/doctors-new-60-long-consultation-for-over-80s-proposed-in-france\/636914#:~:text=A%20new%20&#039;longer%20consultation&#039;%20with,fees%20raised%20across%20the%20board.\" target=\"_blank\" rel=\"noopener\">\u20ac60 \u2018long consultation\u2019 for over 80s<\/a> is set to be introduced.<\/p>\n<p>Available once per year, it will only be possible to have the appointment if a patient has recently been hospitalised, as a way to \u2018combine\u2019 appointments for several medical issues, or as part of a social-medical transition pathway agreed upon by experts.\u00a0<\/p>\n<p>The increases are part of staggered price rises for several specialist appointments agreed between medical unions and France\u2019s Social Security body Assurance Maladie and in most cases follow a first round of increases introduced in December 2024.\u00a0<\/p>\n<p>The incoming tariffs were originally set to be introduced in July 2025, but were pushed back due to concerns over health spending across the year.\u00a0<\/p>\n<p>The new measures come following long negotiations between Assurance Maladie and unions.\u00a0<\/p>\n<p>They aim to improve patient care, particularly outside of hospitals and in rural areas, and adapt primary care to the modern healthcare landscape.<\/p>\n<p>What tariffs are changing?\u00a0<\/p>\n<p>Some of the main increases set to come into force include:\u00a0<\/p>\n<ul>\n<li>\n<p>Visits to a paediatrician for a child under 2, increasing from \u20ac39 to \u20ac40 (prior to December 2024 this was \u20ac38.50). Mandatory check-ups for children under 2 will increase from \u20ac45 to \u20ac50<\/p>\n<\/li>\n<li>\n<p>Visits to a paediatrician for different mandatory check-ups &#8211; known as COEs (at 8 days, 9 months, and two years) will increase from \u20ac54 to \u20ac60. However, unlike for other appointment types this fixed rate applies to all sector 1 and 2 practitioners regardless of if they are signed up to OPTAM, and are reimbursed at a 100% rate by Assurance Maladie (meaning no out of pocket expense for parents)<\/p>\n<\/li>\n<li>\n<p>Visits to a psychiatrist, neuropsychiatrist or neurologist, rising from \u20ac55 to \u20ac57 (prior to December 2024 this was \u20ac51.70). For under 25s, this can increase to \u20ac75<\/p>\n<\/li>\n<li>\n<p>Visits to a gynecologist, increasing from \u20ac37 to \u20ac40 (prior to December 2024 this was \u20ac33.50)<\/p>\n<\/li>\n<li>\n<p>Visits to a geriatrician, rising from \u20ac37 to \u20ac42 (prior to December 2024 this was \u20ac31.50)\u00a0<\/p>\n<\/li>\n<li>\n<p>Visits to a dermatologist for melanoma screening, increasing from \u20ac54 to \u20ac60 (prior to December 2024 this was \u20ac47.50)\u00a0<\/p>\n<\/li>\n<\/ul>\n<p>Will reimbursement rates change too?<\/p>\n<p>Assurance Maladie will continue to reimburse appointments with sector 1 and sector 2 OPTAM doctors at current rates (generally 70%), with most of the rest being paid out-of-pocket or via a patient\u2019s mutuelle.\u00a0<\/p>\n<p>Reimbursement rates for sector 2 doctors not in the OPTAM scheme will remain at current levels.\u00a0<\/p>\n<p>For example an appointment with a non-OPTAM sector 2 gynaecologist has a maximum reimbursement rate of \u20ac23 (excluding mandatory franchises) regardless of the total cost.\u00a0<\/p>\n<p>New model for GP pay\u00a0<\/p>\n<p>Another change sees GPs (m\u00e9decins traitant) paid on an annual flat-rate basis for each patient registered with them. Rates will be based on patient status (age, health, financial hardship), as well as the doctor\u2019s age and location.<\/p>\n<p>This flat-rate ranges from around \u20ac5 for a one-off, otherwise healthy adult, up to \u20ac100 for an over 80 with a long-term illness.\u00a0<\/p>\n<p>Additional supplements for providing certain preventative care, such as flu jabs, will also be paid out.<\/p>\n<p>These payments make up around 15% of a GP\u2019s annual income.\u00a0<\/p>\n<p>This change pertains to GP remuneration and does not change patient consultation fees or statutory reimbursement rules.<\/p>\n<p>Slight changes to surgery and obstetrics payments will also come into play, through an extra \u20ac240 million in funding.\u00a0<\/p>\n<p>Again, this will have no impact on patient costs, but is rather part of agreements between Assurance Maladie and professionals in the sector.\u00a0<\/p>\n<p>A wider overhaul of medical nomenclature and associated payments from Assurance Maladie to specialists is taking place.\u00a0<\/p>\n<p>Around 13,000 definitions and associated payments are being revised by Assurance Maladie and unions, in the first major update of its type in over 20 years.\u00a0<\/p>\n<p>A full list of January 1 changes associated with Assurance Maladie can be found <a href=\"https:\/\/www.assurance-maladie.ameli.fr\/presse\/2025-12-22-cp-convention-medicale-ce-qui-change-en-2026\" target=\"_blank\" rel=\"noopener\">here<\/a>.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"We look at specialists affected and how reimbursement for patients will work for new tariffs The changes in&hellip;\n","protected":false},"author":2,"featured_media":662350,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5309],"tags":[2000,299,36],"class_list":{"0":"post-662349","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-france","8":"tag-eu","9":"tag-europe","10":"tag-france"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/115808282088413740","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/662349","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=662349"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/662349\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/662350"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=662349"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=662349"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=662349"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}