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Speech therapy disorders

As a speech therapist you will find here all speech therapy disorders for which the health insurance reimburses (Article 36 of the nomenclature).

Speech therapist reimbursement conditions
Find a speech therapist

In this section you will find an overview of all speech therapy disorders for which health insurance will reimburse. Each sheet is drawn up according to a clear pattern with a number of fixed sections such as the type of hearings, the maximum number of hearings and a checklist for a complete and correct application.

Nomenclature (art. 36 §2, a)

Oral language or speech disorder that limits the ability to:

  • a profession that makes him subject either to the social security of employees or to the social status of self-employed persons; the job seekers are equated with that category of entitled persons;
  • retraining permitted by the Board of Medical Directors;
  • an apprenticeship agreement that has been recognized in accordance with the conditions laid down in the regulations regarding the continuous training of the middle class.

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 55 individual treatment sessions of at least 30 minutes. If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Exclusions

Students cannot claim a refund.

In addition, all exclusions from §3 remain applicable.

Request checklist

The application for compensation must contain the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b1)

Language or speech disorders : aphasia, more specifically: acquired language disorders as a result of a brain injury of vascular, toxic, tumoral, infectious or traumatic origin.

Type of sessions

Individual sessions of thirty or sixty minutes and collective sessions of sixty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 288 individual treatment sessions of at least 30 minutes. If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • For therapeutic reasons, thirty-minute sessions may be replaced by sixty-minute sessions (except for children under ten years of age), without exceeding the equivalent of a maximum of 288 individual thirty-minute sessions.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.

Exclusions

No refund is possible for stays in:

  • psychiatric care home (PVT) (725xxx…);
  • rest home for the elderly (ROB);
  • rest and care home (RVT).

In addition, all other exclusions from §3 remain applicable.

Important

  • Start treatment
    Treatment should begin within six months of the onset of the condition.

Request checklist

The refund request must include the documents below.

  
Application form
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file. If necessary, the consulting physician may request additional information to make a decision.
     
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (NKO/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, geriatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Etiology, nature and extent of the disorders.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b2)

Disorders in receptive and/or expressive language development

  • demonstrated by a language test that gives a score less than or equal to the criterion values,
  • where there is no intelligence disorder (total IQ 86 or more, measured with an individual test)
  • and no severe hearing impairment (average hearing loss does not exceed 40 dB HL in the better ear).

These language tests, these IQ tests and the criterion values must appear on an exhaustive list approved by the Agreement Committee for Speech Therapists Insurance Institutions.

Type of sessions

Only thirty-minute sessions are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 190 individual treatment sessions of at least 30 minutes.
  • If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • The treatment can be extended up to the age of 17, provided that the beneficiary follows regular education.
  • The treatment cannot be extended if the rights holder has received approval for B3 or F in the meantime.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of certified sessions for the initial balance (issue 701013 - 701083) and for parent guidance:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.

Exclusions

No refund is possible for:

  • speech disorders such as sigmatism, rhotacism, lambdacism, kappacism, cluttering;
  • an application following speech therapy treatment of B3 (learning difficulties) ;
  • language disorders as a result of learning a language other than the mother tongue or a multilingual upbringing.

In addition, all exclusions from §3 remain applicable.

Important

  • Late administration of IQ test
    No approval can be given for the treatment of language development disorders before the date on which the IQ was measured.
    Example: request for speech therapy with a start date of February 15. On February 28, the advising physician will receive the results of the IQ test conducted on February 20. Approval can only be given from February 20.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form
  • Application form for language development disorders (Appendix 98b): completed, dated and signed by the speech therapist and the patient or his legal representative.
    The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial assessment, the IQ test and the audiogram are kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (NKO/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine, surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  
  
  

 

Nomenclature (art. 36 §2, b3)

Dyslexia and/or dysorthography and/or dyscalculia, diagnosed in children up to the age of 14 years, who have completed at least 6 months of primary or secondary education in the language in which the disorders are treated. The impairment must be proven by tests of reading and/or written expression and/or arithmetic, which give two scores less than or equal to the criterion values. The tests and criterion values must correspond to the year in which the beneficiary is enrolled and appear on an exhaustive list approved by the Agreement Committee for Speech Therapists Insurance Institutions.

In addition, the following characteristics must be reported in the balance sheet:

  • the level of accuracy and/or speed (=automation)
  • phonological development (only for dyslexia and dysorthography)
  • the compensatory behaviors, negative attitude, increased effort"
  • the guidance already provided at school and at home

Type of sessions

Only individual sessions of thirty and sixty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 140 individual treatment sessions of at least 30 minutes. If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications. The treatment can be extended up to the age of 17, provided that the beneficiary follows regular education. The treatment cannot be extended if the rights holder has received an approval for F in the meantime.
  • For therapeutic reasons, the thirty-minute sessions may be replaced by sixty-minute sessions (except for children under ten). However, the equivalent of 140 sittings may not be exceeded.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of certified sessions for the initial balance (issue 701013 - 701083) and for parent guidance:
    • an individual parental guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • The prescribing doctor must not specify the duration of the sessions in the prescription.
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.

Exclusions

No refund is possible if:

  • the beneficiary attends special education (not even during holiday periods);
  • the disorders are a consequence of learning a language other than the mother tongue or of a multilingual upbringing;
  • the disorders are the result of psychiatric disorders or emotional states, of relationship problems, of neglected or inadequate school attendance.

In addition, all other exclusions from §3 remain applicable.

Important

  • Age restriction
    Speech therapy treatment must start before the age of 15, so the assessment must also be completed before the fifteenth birthday. The beneficiary is entitled to two years of reimbursement from the date of payment by the insurance institution (even if the age of the person concerned exceeds 14 years).
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Application form for dyslexia and/or dysorthography and/or dyscalculia (appendix 98c): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy
 
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the implementation of the bilan and before the start of the speech therapy treatment .
  

Nomenclature (art. 36 §2, b4)

Disorders due to cleft lips , cleft palate or cleft tooth sockets .

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions and duration of the intervention

  • Age-related
    • Children under 3 years old
      One agreement for a period up to and including the day before the third anniversary.
      Maximum number of sessions: thirty individual sessions of at least thirty minutes.
    • Children from 3 to 19 years old
      Eight agreements, each lasting a maximum of one year. A shorter period is also possible.
      The chords do not have to match each other.
      Maximum number of sessions: 75 individual sessions of at least thirty minutes.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Important

  • Unused sessions
    The unused sessions in the context of an annual agreement cannot be carried over to a subsequent period.

Request checklist

The refund request must include the documents below.

  
Application form
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form. The complete initial bill is kept in the patient's file. If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b5)

Acquired disorders as a result of radiotherapeutic or surgical treatment (head and neck).

Type of sessions

Only individual sessions of thirty minutes and collective sessions of sixty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 55 individual treatment sessions of at least 30 minutes. If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b6.1)

Acquired speech disorders : traumatic or proliferative dysglossias, more specifically disorders resulting from a structural anomaly (congenital, traumatic or tumoral) of the peripheral organs of articulation.

Type of sessions and duration of intervention

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions

  • An agreement of 2 years can be given for a maximum of 149 individual treatment sessions of at least 30 minutes.
    If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  • Already included in the standard template 'bilan voor speechtherapie'.
  

Nomenclature (art. 36 §2, b6.2)

Acquired speech disorders : dysarthria, more specifically acquired motor speech disorders due to central or peripheral nerve damage.

Type of sessions

Only thirty-minute sessions are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 176 individual treatment sessions of at least 30 minutes.
    If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Important

  • Cumulative ban
    For example, a beneficiary who exhibits dysphagia and dysarthria cannot obtain approval for both disorders. The application must be made on the basis of the most pronounced disorder.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b6.3)

Chronic speech disorders:

  • due to neuromuscular disorders included in the list used by the reference centers for neuromuscular disorders,
  • or as a result of Parkinson's disease or Huntington's disease,
  • or as a result of cerebral palsy in children up to the age of 3 years, certified by a neurologist,
  • excluding dementia or symptoms of early dementia.

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 520 individual treatment sessions of at least 30 minutes.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • For these beneficiaries, the treatment may be extended whenever it is determined that a new speech therapy treatment can significantly improve the dysarthria or its consequences in terms of communication. For each two-year extension notification, a maximum of 520 new individual treatment sessions of at least 30 minutes can be certified.

Important

  • Neuromuscular disorders
    The term 'neuromuscular disorders' does not refer to conditions that are either solely neurological or solely muscular in nature. The relevant neuromuscular diseases are listed on this page of the Riziv website (non-exhaustive list).

Request checklist

The refund request must include the documents below.

  
Application form
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a doctor specialist in neurology, neuropsychiatry or pediatric neurology, and this - if the etiology is MS, neuromuscular diseases or cerebral palsy - in the context of his activity in a rehabilitation center contracted with the Riziv or with the federated entities, specialized in integral care of patients with these conditions.
  • Identification and signature of the prescribing physician.
  • Etiology, nature and extent of the disorders.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b6.4)

Stuttering. The severity of stuttering is measured by a test that appears on an exhaustive list approved by the Commission for agreements with speech therapists.

Type of sessions

Both individual sessions of thirty minutes and individual and collective sessions of sixty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 128 individual treatment sessions of at least 30 minutes. If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of certified sessions for the initial balance (issue 701013 - 701083) and for parent guidance:
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.

Important

  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Application form for stuttering (appendix 98d): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, b6.5)

Frequent functional disorders in relation to an orthodontic disorder .

Type of sessions

Individual sessions of thirty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 20 individual treatment sessions of at least 30 minutes.
    If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Important

  • Cumulative
    At the same time, approval can be given for speech therapy treatment of other disorders mentioned in Article 36 §2 and disorders in relation to an orthodontic disorder . But only one session per day can be reimbursed.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • An orthodontist or dentist is therefore not allowed to prescribe a bilan.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a doctor specialist in oto-, rhino-, laryngology (ENT/ORL) or stomatology, by a general dentist or a dental specialist in orthodontics.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, c1)

Acquired voice disorder: sequelae of laryngectomy.

Type of sessions

Individual sessions of thirty minutes and collective sessions of sixty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 90 individual treatment sessions of at least 30 minutes.
    If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, c2)

Dysfunction of the larynx and/or vocal folds demonstrated on the basis of:

  • laryngoscopy and stroboscopy
  • and perceptual data, acoustic and aerodynamic measurements with tests and criteria included in the committee-approved list of tests for voice disorders
  • and measurements of the impact of the voice problems on the patient's quality of life using tests and criteria included in the Approved List of Tests and Trials for Voice Disorders.

Type of sessions

Only individual sessions of thirty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 80 individual treatment sessions of at least 30 minutes.
    If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of certified sessions for the initial balance (issue 701013 - 701083) and for parent guidance :
    • an individual parent guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.

Exclusions

Voice disorders such as acute functional aphonia (no voice), dysphonia (hoarseness), phonasthenia (voice weakness) and voice alternation disorders are not eligible.

In addition, all other exclusions from §3 remain applicable.

Important

  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Application form for voice disorders - c2 (appendix 98e): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill and examinations/tests are kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (ENT/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, d)

To the beneficiary with hearing disorders that involve an average hearing loss of at least 40 dB HL in the better ear.

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 520 individual treatment sessions of at least 30 minutes.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of certified sessions for the initial balance sheet (issue 701013 - 701083) and for parent guidance:
    • an individual parental guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • For these beneficiaries, the treatment may be extended provided that the prescription is issued by a specialist in rehabilitation affiliated with a rehabilitation center contracted with the Insurance Committee of the Medical Care Service or with the federated entities specialized in the full care of these patients. For each 2-year extension notification, a maximum of 520 new individual treatment sessions of at least 30 minutes can be certified. The parent guidance sessions count towards the maximum number of reimbursable sessions.

Important

  • Cumul rehabilitation center
    Patients with hearing disorders must follow or have followed a rehabilitation program with speech therapy in a conventional rehabilitation center that is specialized in treating these problems. One can therefore follow both mono- and multidisciplinary therapy in the same period but not on the same day.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a doctor specialist in oto-, rhino-, laryngology (ENT/ORL), neurology or pediatric neurology. The prescriber must be affiliated with a conventional rehabilitation center specialized in these problems.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  

Nomenclature (art. 36 §2, e)

Dysphagia that threatens oral nutritional and fluid intake or with a risk of aspiration .

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 65 individual treatment sessions of at least 30 minutes.
    If the maximum number of 30-minute sessions is not reached, the remaining sessions may be used in the context of one or more two-year extension notifications.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).

Children under three years old

For children under 3 years of age for whom a fluoroscopic examination (VFES or FEES) cannot be performed, the file must be sent to the health insurance fund's advisory physician , stating the reasons .

The file is then submitted to the Committee for agreements with the speech therapists.

The file must contain the following elements to be eligible:

  • medical justification as to why neither of the two stated objective examinations can be carried out on the child;
  • all data from the patient's medical file that are directly or indirectly related to or could explain the disorder for which reimbursement is requested;
  • therapeutic plan of the proposed swallowing rehabilitation, which at least states how the feeding process is stimulated, on the basis of which improvement is expected and how the risks are estimated.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial assessment and the VEFS or FEES examination are kept in the patient's file. If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Prescription from a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a physician specialist in oto-, rhino-, laryngology (NKO/ORL), neurology, neuropsychiatry, psychiatry, pediatric neurology, neurosurgery, internal medicine, oncology, gastroenterology, pediatrics, geriatrics, stomatology, physical medicine or surgery.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  
  

Nomenclature (art. 36 §2, f)

To the beneficiary with dysphasia, that is

  • severe expressive and/or receptive language disorders
  • that persist persistently beyond the fifth birthday and
  • that seriously interfere with social communication and/or daily activities that involve oral language,
  • in absence of
    • a pervasive developmental disorder,
    • a hearing disorder (the average hearing loss in the better ear does not exceed 40 dB HL),
    • an intelligence disorder (performance or non-verbal IQ or OQ (developmental quotient) of 86 or more, measured with an individual test on an exhaustive list approved by the Agreements Committee for Speech Therapists Insurance Institutions.

 

The disorder must be demonstrated by means of individually administered standardized tests that give a score less than or equal to the criterion values for at least one aspect (expressive or receptive) in at least three domains (phonology (including metaphonology), vocabulary/semantics, morphology, syntax ).

These tests and criterion values must appear on an exhaustive list approved by the Agreement Committee for Speech Therapists Insurance Institutions.

Type of sessions

Individual sessions of thirty and sixty minutes are permitted.

Maximum number of sessions and duration of the intervention

  • An agreement of 2 years can be given for a maximum of 384 individual treatment sessions of at least 30 minutes.
  • These maximums for individual sessions of thirty minutes must be reduced by the number of certified sessions for the initial balance (issue 701013 - 701083) and for parent guidance:
    • an individual parental guidance session of sixty minutes counts for two individual sessions of thirty minutes;
    • a collective parent guidance session of ninety minutes counts for an individual session of thirty minutes.
  • Each certified provision for an individual session of sixty minutes corresponds to two certified provisions for an individual session of thirty minutes.
  • The treatment can be extended up to the age of 17, provided that the beneficiary follows regular education. Per notification of 2-year extension, a maximum of 192 new individual treatment sessions of at least 30 minutes can be certified.

Exclusions

  • Speech disorders such as sigmatism, rhotacism, lambdacism, kappacism, cluttering.
  • Language disorders as a result of learning a language other than the mother tongue or a multilingual upbringing.
  • All other exclusions from §3.

Important

  • Place of treatment
    During the continuous period of two years, the beneficiary may only be treated at school five times per calendar month. Sessions at school are no longer permitted after the uninterrupted period of two years.
  • Parental guidance
    Parental guidance can be certified for this disorder. Strategies are learned to support the child's speech therapy treatment with targeted interventions and make it more efficient.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Application form for dysphasia (appendix 98f): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial assessment, the IQ test and the audiogram are kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Drawn up by a pediatric neurology specialist.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy
  • Drawn up by a pediatric neurology specialist.
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  
  
  

Nomenclature

Speech, swallowing and language disorders related to Locked-in Syndrome (LIS).

Type of sessions

Only individual sessions of thirty minutes are allowed.

Maximum number of sessions and duration of the intervention

  • An agreement can first be given for a maximum of 150 individual treatment sessions of at least 30 minutes, over an uninterrupted period of one year.
  • This maximum for individual sessions of thirty minutes must be reduced by the number of attested sessions for the initial balance sheet (issue 701013 – 701083).
  • The treatment may be extended for periods of one year after the aforementioned continuous period of one year, for life. For each 1-year extension notification, a maximum of 100 new individual treatment sessions of at least 30 minutes can be certified.

Request checklist

The refund request must include the documents below.

  
Application form
 
  • Standard application form (appendix 98a): completed, dated and signed by the speech therapist and the patient or his legal representative. The application for compensation and the summary of the results of the initial assessment are brought together in this application form.
    The complete initial bill is kept in the patient's file.
    If necessary, the consulting physician may request additional information to make a decision.
Prescription for speech therapy bilan
  • Drawn up by a doctor with an active Riziv number.
  • Identification and signature of the prescribing physician.
  • Dated before the implementation of the bill.
Prescription for speech therapy treatment
  • Drawn up by a doctor specialist in neurology, neuropsychiatry, pediatric neurology or neurosurgery
  • Identification and signature of the prescribing physician.
  • Dated after the performance of the bilan and before the start of the speech therapy treatment.
  
  

Also read

Speech therapist reimbursement conditions
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