CNS Reimbursements Luxembourg 2026: Rates, Timelines, PID
The CNS (Caisse Nationale de Santé) reimburses 88% of medical costs for adults and 100% for children under 18. The co-payment (personal contribution) is 12% for in-office consultations, 20% for home visits, and ranges from 20% to 100% for medication depending on classification. Since March 2024, the Paiement Immédiat Direct (PID) system means you no longer need to pay the CNS share upfront at 600+ doctors and dentists — you only pay your co-payment on the spot. Reimbursement timeline: 1 to 8 weeks depending on complexity. Claim deadline: maximum 2 years after payment.
100% reimbursement with supplementary health insurance
The CNS covers 88%, a supplementary policy takes care of the remaining 12% plus fee overruns.
Compare health insurance plans →CNS reimbursement rates by type of care 2026
The CNS reimbursement system uses differentiated rates depending on the type of care and the patient’s age. The basic principle: 88% reimbursement for adults (≥ 18 years) on most medical services, and 100% coverage for children and young people under 18. These rates apply to the official tariffs set by the CNS nomenclature, not to any fee overruns charged by certain doctors.
| Type of care | CNS adults (≥ 18) | CNS children (< 18) | Co-payment | Practical example |
|---|---|---|---|---|
| GP consultation (in-office) | 88% | 100% | 12% | C1: €59.50 → CNS €52.36 → you pay €7.14 |
| Specialist (in-office) | 88% | 100% | 12% | €49.70–88.80 → CNS 88% → you pay 12% |
| Home visit | 80% | 100% | 20% | €95 → CNS €76 → you pay €19 |
| Psychotherapy (since Feb. 2023) | 70% | 100% | 30% | €158.95 → CNS €111.27 → you pay €47.69 |
| Standard physiotherapy | 70% | 100% | 30% | €31.50 → CNS €22.05 → you pay €9.45 |
| Intensive physiotherapy | 100% | 100% | 0% | €31.50 → CNS €31.50 → you pay €0 |
| Lab tests and analyses | 80% | 100% | 20% | Blood test €30 → CNS €24 → you pay €6 |
| Imaging (X-ray, CT, MRI) | 80% | 100% | 20% | MRI €400 → CNS €320 → you pay €80 |
| Hospital (standard class) | 100% medical fees | 100% | €26.14/day | 5 days → CNS 100% fees + daily charge €130.70 |
| Conservative dental care | 88% | 100% | 12% | Filling €100 → CNS €88 → you pay €12 |
| Medication (preferential rate) | 100% | 100% | 0% | Essential drug €50 → CNS €50 → you pay €0 |
| Medication (standard rate) | 80% | 100% | 20% | €40 → CNS €32 → you pay €8 |
| Medication (reduced rate) | 40% | 40% | 60% | €25 → CNS €10 → you pay €15 |
| Midwife (pre/postnatal) | 100% | 100% | 0% | Consultation €45 → CNS €45 → you pay €0 |
| Maternity (standard class) | 100% | 100% | €26.14/day | Delivery + stay → CNS 100% fees → daily charge remains |
Sources: CNS reimbursed services, CNS nomenclature, Luxembourg Social Security Code — tariffs June 2026.
Good to know — The 88% and 100% rates apply ONLY to the official CNS tariffs, not to fee overruns. If your doctor charges €80 for a consultation with an official CNS tariff of €59.50, the CNS reimburses 88% of €59.50 = €52.36. The €20.50 overrun remains entirely at your expense. Supplementary health insurance covers the 12% co-payment plus overruns within certain limits (€500–1,500/year depending on insurer).
Important point about children: 100% coverage applies to all minors under 18 residing in Luxembourg or co-insured on a parent’s CNS account. This rule applies automatically without any special steps, as long as the child’s 13-digit national identification number appears on the medical invoice. Parents pay NOTHING at the doctor, dentist or pharmacy for their children (except reduced-rate medication at 40% and non-reimbursed fee overruns).
Psychotherapy specifics: since February 2023, the CNS reimburses psychotherapy at 70% for adults and 100% for children, subject to 4 strict conditions: (1) compulsory medical prescription from a GP or psychiatrist, (2) sessions conducted by a psychotherapist recognised by the Ministry of Health (official list available), (3) in-person sessions only (teleconsultation NOT reimbursed), (4) submission of the medical invoice with prescription within 2 years. This major step forward has made psychotherapy accessible to thousands of Luxembourg residents and cross-border workers who previously could not afford it (official CNS rate: €158.95/session).
Immediate Direct Payment (PID): no more upfront costs
The Paiement Immédiat Direct (PID) is the most modern CNS reimbursement system, launched in September 2023 (GP pilot phase) and then extended to all doctors and dentists from 19 March 2024. By late 2026, over 600 healthcare professionals are using PID in Luxembourg (around 20% of all services). The principle: you only pay YOUR personal contribution (12%, 20% or 30% depending on the service), while the CNS instantly transfers its share (88%, 80% or 70%) directly to the doctor’s bank account within seconds.
Before PID: the traditional system
You visit your GP, fee €59.50. You pay €59.50 in full by card or cash. The doctor gives you a paper invoice stamped « paid ». You go home, put the invoice in an envelope and post it to the CNS (address L-2980 Luxembourg, no stamp needed from Luxembourg). The CNS processes your claim in 2–8 weeks. You receive a bank transfer of €52.36 (88% of €59.50). Problem: you’ve advanced €59.50 for 2–8 weeks, which is a burden for families on modest incomes or with multiple consultations (family of 4 = €238 advanced).
With PID: instant payment
You visit the same doctor, same fee of €59.50. The doctor electronically validates your invoice via their CNS-approved software. The system automatically calculates the CNS share (€52.36) and your contribution (€7.14). You pay ONLY €7.14 on the spot by card or cash. Simultaneously, the CNS instantly transfers €52.36 to the doctor’s bank account (SEPA Instant transfer). You receive an electronic PID statement via MyGuichet.lu or by email. No more advancing costs, no more postal mail, no more waiting. Particularly beneficial for families: a child’s consultation of €59.50 → you pay €0 (100% coverage).
PID technical requirements
Doctor’s side: CNS-approved billing software compatible with mySecu/e-santé web services (e.g. Doctipro). Secure internet connection. Bank account with a SEPA Instant-compatible bank (BCEE/Spuerkeess, BGL BNP Paribas, Raiffeisen, BIL, ING Luxembourg). Patient’s side: no action required, no prerequisites. Up-to-date CNS card (13-digit national identification number). Works for all CNS, CMFEP, CMFEC and EMCFL members. The doctor verifies your membership in real time via the CNS system. Installation incentive: €625 paid to the software publisher for each new PID connection, plus €0.44 (excl. VAT) compensation per successful PID transaction paid to the doctor.
Services covered by PID
Included since 19 March 2024: all consultations and services in the doctors’ nomenclature (C1, C2, C3, CS1, etc.), dentists’ nomenclature (scaling, fillings, conservative care), and certain in-office lab services. Current exceptions: services requiring prior CNS approval (major orthodontics, major dental prostheses), services outside the CNS nomenclature, work-related accidents (AAA jurisdiction), and social third-party payment. The scope is gradually expanding to cover as many services as possible by 2026.
Key PID limitation — Under the CNS-AMMD agreement, the system covers only ONE consultation per GP or specialist of the same medical discipline per 24-hour period. If you see 2 GPs on the same day, only the 1st consultation benefits from PID; the 2nd is at your expense (standard reimbursement can be claimed afterwards). Exception: medical emergency or prior CNS authorisation.
How to find out if your doctor offers PID? There is no public list of PID-enabled doctors. Solution: ask your doctor directly when booking your appointment or upon arrival at the practice. Most modern practices display a « PID available » sticker at the entrance. In 2026, around 20% of services are settled via PID; this figure is expected to reach 50–60% by 2026.
What to do with the PID statement you receive? The PID invoice must NOT be sent to the CNS, as payment has already been made directly. However, keep this statement and forward it to your supplementary health insurer if you have one. Supplementary insurers (DKV, Foyer, AXA, CMCM) reimburse your 12% personal contribution on presentation of the PID statement. Example: consultation €59.50, you paid €7.14 to the doctor via PID. Send the statement to DKV → you recover €7.14 → total reimbursement 100%.
Recover your 12% co-payment with the right supplementary health insurance.
Compare plans →Co-payment and personal contribution
The co-payment (or personal contribution) is the share of medical costs that remains at your expense after CNS reimbursement. In Luxembourg, co-payments range from 0% to 60% depending on the type of care, but mainly centre around 12% for adult medical consultations. Unlike France, where the co-payment is often a flat fee (€1 per consultation), in Luxembourg it is proportional to the cost of the service.
| Situation | Cost | CNS | Co-payment | Out-of-pocket |
|---|---|---|---|---|
| Adult — GP | €59.50 | 88% = €52.36 | 12% | €7.14 |
| Child — GP | €59.50 | 100% = €59.50 | 0% | €0 |
| Adult — home visit | €95 | 80% = €76 | 20% | €19 |
| Adult — psychotherapy | €158.95 | 70% = €111.27 | 30% | €47.69 |
| Adult — MRI | €400 | 80% = €320 | 20% | €80 |
| Essential medication | €50 | 100% = €50 | 0% | €0 |
| Standard medication | €40 | 80% = €32 | 20% | €8 |
| Reduced-rate medication | €25 | 40% = €10 | 60% | €15 |
Sources: CNS Immediate Direct Payment, Luxembourg Social Security Code — data June 2026.
Annual accumulation of co-payments: if your personal contributions exceed a certain threshold based on your contributory income, you can apply for supplementary CNS reimbursement. The threshold is set at 2.5% of the previous year’s annualised contributory income. Example: 2024 contributory income = €36,000/year → 2025 threshold = €900. If your cumulative co-payments reach €1,100 in 2025, you can claim reimbursement of the excess, i.e. €200.
Reimbursement timelines and claim deadlines
The CNS processes reimbursement claims using a 3-speed system based on case complexity. The timelines listed are averages observed in 2026 but may vary depending on the CNS workload.
Express reimbursement: 1 week (20% of invoices)
Applies to simple, standardised invoices — code C1 consultations (basic GP), invoices compliant with CNS recommendations (« paid » stamp, doctor’s signature, legible identification number). Processing: automated optical reading (OCR), validation and transfer within 3–7 working days. Tip: send several invoices in the same envelope — they will be processed together.
Standard reimbursement: 2–4 weeks (60% of invoices)
Applies to invoices requiring manual review — specialist consultations, multiple services, prescriptions to verify (physiotherapy, tests), dental care, foreign invoices. Average timeline: 14–28 working days. If a document is missing, the CNS sends a letter requesting the supplement and the timeline restarts.
Complex reimbursement: 5–8 weeks (20% of invoices)
Applies to complex cases — hospitalisation, dental prostheses requiring prior approval, treatment abroad, referral to the Medical Review Board (CMSS). Average timeline: 35–56 working days. Contact the CNS (+352 2757-1) if the timeline is exceeded.
Claim deadline: 2 years maximum
You have 2 years from the date of payment to submit your reimbursement claim to the CNS. After this deadline, your claim will be automatically refused with no exceptions (Article 84, Luxembourg Social Security Code). Advice: send your invoices as soon as you pay them.
Fast reimbursement tip — Visit a CNS agency in person with your invoices (minimum €100 per household) for immediate reimbursement by cheque or instant transfer. Condition: appointment within 15 calendar days of payment. Book via: CNS website, « Agencies » section.
Standard reimbursement procedures (without PID)
If your doctor does not yet offer PID, you must follow the standard reimbursement procedure by posting your claim to the CNS.
Pay the doctor and obtain the invoice
After your consultation, you pay the full amount. The doctor gives you an original medical invoice that must include: (1) the CNS service code, (2) the amount charged, (3) your 13-digit national identification number, (4) the note « POUR ACQUIT » + signature/stamp. Without these 4 items, your invoice will be rejected. Always keep a copy before sending.
Attach proof of payment if necessary
If the invoice bears the « POUR ACQUIT » note with signature: no additional proof is needed. Otherwise, attach a bank debit notice, transfer copy or card receipt. A simple monthly bank statement is not sufficient.
Attach the prescription if applicable
Prescription required for: laboratory tests, medical imaging, physiotherapy, psychotherapy, certain medications. Attach the ORIGINAL prescription dated no more than 2 months before the service. For physiotherapy, the CNS issues a coverage certificate (8, 16 or 64 sessions depending on the condition).
Post your documents to the CNS
Address: CNS, L-2980 Luxembourg. No stamp needed from Luxembourg. From abroad (cross-border workers), international postage is required. Group several invoices in one envelope. You can also drop off invoices at a CNS agency without an appointment.
Common mistakes to avoid — (1) Sending photocopies instead of originals → rejection. (2) Invoice without legible identification number → cannot be processed. (3) Forgetting the prescription → extended delay. (4) Sending after 2 years → inadmissible. (5) Not keeping a copy → impossible to dispute.
Tracking: you will receive a reimbursement statement by post (1–8 weeks). Activate eDelivery on MyGuichet.lu to receive it as a PDF. The bank transfer is made 2–3 days after the statement is issued.
CNS nomenclature and tariffs
The CNS nomenclature is the official reference that sets the codes and tariffs for all reimbursed medical services in Luxembourg. Each service has a unique code and a fixed official tariff to which the CNS reimbursement rate is applied.
| Code | Service | CNS tariff | Adult rate | CNS amount |
|---|---|---|---|---|
| C1 | GP consultation (in-office) | €59.50 | 88% | €52.36 |
| C2 | Extended GP consultation | €89.25 | 88% | €78.54 |
| CS1 | Specialist consultation | €49.70–88.80 | 88% | €43.74–78.14 |
| V1 | Home visit | €95 | 80% | €76 |
| DC1 | Dentist consultation | €40.70 | 88% | €35.82 |
| KS1 | Physiotherapy session (standard) | €31.50 | 70% | €22.05 |
Official tool: CNS Tariffs explained — updated codes and tariffs June 2026.
Fee overruns: Luxembourg doctors may charge fees above the official tariffs, identified by codes CP1 to CP7 (doctors) or CP1 to CP8 (dentists). These personal convenience charges are NEVER reimbursed by the CNS. Example: C1 €59.50 + CP1 €20 = €79.50 → CNS reimburses €52.36 → out-of-pocket €27.14. Supplementary health insurance can partially cover these overruns.
Third-party payment and automatic coverage
Third-party payment means you only pay YOUR personal contribution, with the CNS settling its share directly with the provider.
Pharmacies (automatic)
All prescription medication benefits from third-party payment. You only pay the co-payment. The pharmacist bills the CNS directly. Present your CNS card + prescription (less than 2 months old).
Hospitalisation (automatic)
Standard-class hospital stays benefit from third-party payment for medical fees (CNS 100%). Remaining at your expense: daily contribution of €26.14/day (€13.07/day for day hospital). Children under 18: no contribution.
Physiotherapy (with CNS coverage certificate)
Prescribed physiotherapy requires a CNS coverage certificate (8, 16 or 64 sessions). Whether third-party payment applies depends on the practice.
Home nursing care
Prescribed nursing care benefits from third-party payment. The nurse bills the CNS directly.
Social third-party payment: a scheme for people on low incomes, managed by municipal social welfare offices. The patient pays nothing.
Supplementary reimbursement: 2.5% income cap
The CNS supplementary reimbursement (Article 154bis of the CNS statutes) protects insured members with high healthcare costs. If your cumulative personal contributions exceed 2.5% of the previous year’s annualised contributory income, you can claim reimbursement of the excess.
Supplementary reimbursement calculation
Step 1 — Calculate your threshold: gross monthly contributory income × 12 × 2.5% = annual threshold. Example: €3,000/month → €36,000 → threshold = €900.
Step 2 — Add up your contributions: the running total appears on the back of each CNS reimbursement statement. Example: 2025 total = €1,100.
Step 3 — Calculate the excess: €1,100 – €900 = €200 reimbursable.
Step 4 — Submit your claim: online form on MyGuichet.lu, before 31 December of year N+2.
Minimum threshold: a minimum amount is set each year by the CNS. Check the CNS website for the current threshold.
Contributions taken into account: consultations, medication, tests, physiotherapy, dental care, optical, hearing aids. Co-insured dependants’ contributions (spouse, children) are combined with yours. Not included: fee overruns (CP codes), services outside the nomenclature.
How to improve your reimbursements
The CNS system is generous (88% on average), but leaves out-of-pocket costs: the 12% co-payment, fee overruns, and services outside the nomenclature. Here are strategies to optimise your reimbursements.
Take out supplementary health insurance
The most effective way to achieve 100% reimbursement. Luxembourg supplementary health insurers (DKV, Foyer, AXA, CMCM) reimburse your 12% co-payment + fee overruns + services outside the CNS (alternative medicine, dental implants, laser eye surgery). Cost: €30–85/month. Immediately worthwhile if you have dental, optical or alternative medicine needs.
Choose doctors who offer PID
No longer advancing costs is a major financial advantage. Always ask your doctor if they offer PID. You pay only €7 instead of €60 for a consultation.
Apply for supplementary CNS reimbursement
If your annual medical costs exceed 2.5% of your income, check each December the running total of your contributions and apply online.
Avoid fee overruns
Ask in advance whether the doctor charges overruns. CP codes are never reimbursed by the CNS. Compare with other practitioners if overruns are high.
Send invoices promptly
The sooner you send your invoices, the sooner you’re reimbursed. Recommended routine: send once a month in a single envelope.
Frequently asked questions about CNS reimbursements
What is the CNS reimbursement rate for a medical consultation?
The CNS reimburses 88% of the official tariff for in-office consultations for adults (18+), i.e. €52.36 out of €59.50. The 12% co-payment (€7.14) remains at your expense. For children under 18, reimbursement is 100%. Home visits are reimbursed at 80% for adults.
What is the Immediate Direct Payment (PID) and how do I benefit?
The PID is an instant payment system where you only pay your personal contribution to the doctor, while the CNS transfers its share instantly. Available since March 2024 for all doctors and dentists, it is used by over 600 professionals in 2026. Ask your doctor if they offer PID. No action required on your part. Forward the PID statement to your supplementary insurer to recover your co-payment.
How long does it take to receive a CNS reimbursement?
20% of invoices within 1 week (simple invoices, automatic processing). 60% within 2–4 weeks (manual review). 20% within 5–8 weeks (complex cases). For immediate reimbursement, visit a CNS agency (minimum €100, by appointment within 15 days).
What is the maximum deadline to claim a reimbursement?
2 years maximum from the date of payment (Article 84, Social Security Code). After this deadline, automatic refusal with no exceptions.
Do children have different reimbursement rates?
Yes, children under 18 benefit from 100% reimbursement for virtually all medical services. No co-payment. With PID, parents pay nothing for a child’s consultation.
How can I get 100% reimbursement in Luxembourg?
Take out supplementary health insurance that covers your 12% co-payment + fee overruns. Luxembourg insurers (DKV, Foyer, AXA, CMCM) reimburse the portion not covered by the CNS on presentation of the reimbursement statement or PID receipt. → Compare health insurance plans
Are fee overruns reimbursed by the CNS?
No, fee overruns are NEVER reimbursed by the CNS. The CNS reimburses only based on official tariffs. CP codes (personal convenience charges) remain at your expense. Supplementary health insurance can partially cover them.
What is the supplementary CNS reimbursement?
A solidarity mechanism that reimburses the excess if your contributions exceed 2.5% of your annualised contributory income. A minimum threshold is set each year by the CNS. Apply via MyGuichet.lu, before 31/12 of year N+2.
Can I be reimbursed for treatment received abroad?
Yes, the CNS reimburses care in the EU/EEA/Switzerland. Emergency care: present your European Health Insurance Card (EHIC). Planned treatment: request prior authorisation (S2 form). Note: care in your country of residence (cross-border workers) is reimbursed by your local fund, not the CNS. → Cross-border worker details
Should I send the PID statement to the CNS?
No, NEVER send it to the CNS. Payment has already been made directly. Keep the PID statement and forward it to your supplementary insurer to recover your 12% contribution. The statement is also accessible on MyGuichet.lu.