From July 1, 2024, a new agreement from the National Institute for Health and Disability Insurance (INAMI) modifies the reimbursement conditions for patients suffering from long COVID. This agreement aims to maintain access to essential care while adjusting certain aspects of care to optimize resources.
Under this new agreement, access to psychological, neurocognitive, dietary, physiotherapy and occupational therapy support remains included, thus guaranteeing continuity of care for patients with persistent symptoms of COVID-19.
Exclusion of speech therapy from reimbursement
A change introduced by this agreement is the cessation of reimbursement for speech therapy care. This decision is justified by the low number of consultations recorded under previous conventions. The majority of patients could already benefit from reimbursements for similar care under other headings, thus reducing the need for specific reimbursement for speech therapy.
Simplification of procedures
In an effort to make access to care more accessible, the care pathway model and multidisciplinary consultation are eliminated. From now on, multidisciplinary consultation will be replaced by a start-up code that the general practitioner can bill for the initial support and follow-up of a patient with long COVID. This simplification is designed to reduce bureaucracy and facilitate faster access to necessary care.
Who is eligible for reimbursement?
Patients with persistent symptoms at least four weeks after acute COVID-19 infection are eligible for this reimbursed care. A prior diagnosis by a general practitioner or specialist is required to begin the treatment process.
Support procedure
Once the diagnosis is made, the doctor, whether general practitioner or specialist, will work with the patient to determine the necessary care adapted to his or her personalized health goals. The necessary prescriptions will be established so that the different care providers can intervene effectively.
- a physiotherapist
- a psychologist
- a neuropsychologist
- an occupational therapist
- and/or a dietician.
If the treatment plan is established by a specialist doctor, he or she will send it to the general practitioner so that the latter can support and monitor the patient.
How to continue treatment started before July 1, 2024?
If a patient started treatment before July 1, 2024, here is how it can be continued depending on the start date of the treatment. For treatments initiated before or on December 31, 2023, care will continue to be certified according to the provisions of the July 1, 2023 agreement, guaranteeing continuity in care. For treatments started between January 1 and June 30, 2024, there are two possibilities: the doctor can choose to continue the care pathway in accordance with the rules of the July 1, 2023 agreement, taking into account the history of services already provided, or to end the current care pathway and start a new treatment plan according to the provisions of the new agreement. In the latter case, it is important to note that the history of services provided up to June 30, 2024 will not be taken into account for the calculation of the maximum number of sessions under the new agreement.
Guidance for healthcare professionals
Specific guidelines have been developed to assist GPs and other healthcare providers in implementing this new agreement. These guidelines, developed by the ebpracticenet network, ensure that professionals have the information and tools they need to optimally manage long COVID cases.
> More information on the Inami website
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