A CT scan has been prescribed for you by your doctor.
This medical imaging technique, based on X-ray technology, allows the exploration of internal organs that are difficult to visualize with x-rays.
The images produced in the form of horizontal sections, after computer processing, make it possible to reconstruct the anatomical structures in 2D or 3D.
The cost of the scanner may be higher or lower and is not always fully covered.
Let's take stock of the reimbursement of a scanner with or without mutual insurance.
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How much does a scanner cost?
A scale defines a reimbursement rate for each medical imaging procedure (radiology, ultrasound, scanner, MRI).
The price of a scanner consists of:
a technical package, full or reduced, that is to say established according to the depreciation period of the devices.
The full rate applies to depreciated devices (in place for more than 7 years as of January 1 of the year of the examination) and the reduced rate relates to activity segments.
The cost varies from €32 to €93.03 for a reduced rate and from €100 to €200 for a full rate.
medical fees, which vary depending on the part of the body examined: thorax and heart: €25.27, thorax, abdomen and pelvis €50.54, arthrography of an upper limb: €79.80, arthrography of a limb lower: €93.10.
An injection of contrast product before the scan is sometimes prescribed to make certain parts of the body more visible.
The price of a scanner with injection is in fact more expensive.
The price of scanners is determined according to the Common Codification of Medical Acts (CCAM).
The medical procedure is reimbursed by health insurance at 70% of the reimbursement base (BRSS), while the technical package is entirely covered by Health Insurance.
The mutual health insurance supplements this reimbursement by covering the co-payment at a more or less high rate.
The scanner reimbursement can be 100% in the following cases:
patients suffering from certain serious pathologies requiring care over a period of more than 6 months, in long-term illness (ALD),
beneficiaries of State Medical Aid (AME), allowing foreigners in an irregular situation, subject to conditions of resources and residence, to benefit from free care,
beneficiaries of complementary solidarity health insurance (CSS), formerly (CMU).
How will the scanner be reimbursed by mutual health insurance?
To minimize your out-of-pocket costs for your scanner and in the event of excess radiologist fees, you must have taken out complementary health insurance with a reimbursement rate of 150% or more.
The higher the rate, 150, 200 or 300%, the greater the reimbursement will be.
The prescription of a radiology procedure, a scanner in particular, is often essential to clarify a diagnosis, particularly for organs or tissues that are difficult to visualize with an x-ray.
To avoid significant health expenses, it is better to take out mutual health insurance allowing maximum reimbursement while preserving your budget.
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How to get reimbursed for a scanner?
To obtain a good reimbursement, a few rules apply:
respect the care pathway, otherwise the Social Security reimbursement will only be 30% of the conventional rate.
favor sector 1 medical imaging practices applying pricing without fee overruns.
Sector 2 approved radiologists charge free fees, however they are set with “tact and moderation”.
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