Since 11/01/2023, the rates for social security agreements for doctors in Metropolitan France are, for a coordinated basic consultation, in sector 1 and sector 2:
- Generalists: €26.50 (€31.50 for children under 6 years old);
- Specialists: 31,50 €.
Particularities:
- Pediatricians 33,50 € for children aged 2 to 6 years;
- Psychiatrists, neuropsychiatrists or neurologists: €51.70;
- Specific consultation with a cardiologist €54.00;
- The one-time consultant opinion is 56.50 € for specialists in general and 64 € for psychiatrists, neuropsychiatrists and neurologists;
- Complex consultation: €47.50.
References : Ameli.
Doctors can practice in 3 sectors:
- The doctors in sectors 1 and 2 are affiliated with the mandatory regime (Social security):
- Conventioned sector 1: The rates are those of the social security reimbursement base.
- Sector 2 agreement with free fees: The rate is free but must remain moderate compared to the social security reimbursement base.
- The doctors in sectors 3 are not under agreement. The rates are set freely by the doctor. Patients are then reimbursed on the basis of the very low ‘authority fee’ (less than €2).
The ‘in addition’ rate of the social security base is called ‘overpayment’.
Even for sectors 1 and 2, social security reimburses only a part of the convention rate (the reimbursement rate for consultations is 70% for example). The balance between the convention rate and the social security reimbursement is called the ‘co-payment’ fee.
For those who have one, the responsible health supplements reimburse at least the moderator’s ticket. Moreover, if the guarantees are sufficiently high, they can reimburse all or part of the fee overruns.
