The report is available in English with a French summary - KCE

224 Musculoskeletal & Neurological Rehabilitation KCE reports 57
in Figure 10.4. Concerning the wage cost of the speech therapist it should be noted that
for this exercise the cost of a therapist with an “A1” degree was used whereas there
are also speech therapist with a university degree. So in the future a possible increase in
this cost should be taken into account.
Figure 10.4: Annual wage costs and costs per hour of human resources
inputs (Euro)
Annual cost Cost per hour
Medical input
Rehabilitation specialist 120 402 74.05
Paramedical input
Physical therapist 63.840 39,26
Occupational therapist 49.497 30,44
Speech therapist 49.497 30,44
Psychologist 63.840 39,26
Social worker 49.497 30,44
Sports therapist 63.840 39,26
Nurse 49.497 30,44
Combined with the number of weeks, hours per week and sessions per week specified
by the reference rehabilitation path (protocol) total staff costs can be calculated for the
selected pathologies and their subgroups.
10.2.2 Calculation of revenues and RIZIV expenditures
The theoretical revenues and RIZIV expenses of the centres providing on average
rehabilitation services according to the protocols defined by the experts are estimated
by applying the current reimbursement mechanisms for musculoskeletal and
neurological rehabilitation in Belgium to the rehabilitation protocols of the five
pathologies under consideration. Given that different pathologies can be treated within
different reimbursement systems (K30/K60 nomenclature, convention 9.50 and/or
convention 7.71), three scenarios were built to estimate the range of likely revenues
associated with the rehabilitation protocols.
Currently, THR can only be reimbursed by means of K30/K60 nomenclature.
Moreover, a royal decree for the implementation of a K45-nomenclature for large joint
replacement is waiting for publication. A K45 will probably be worth €46.62 and
represents a session of 90 minutes.
All other pathologies can be treated either by K30/K60 or by a 9.50 convention. With
the exception of LEA below knee, all pathologies included in the 9.50 convention can in
principle also be treated in a 7.71 centre. We should note that the K30/K60 system is
insufficient to finance the entire treatment path as defined by the experts for LEA above
knee, SCI, MS and stroke, as more sessions are needed for these pathologies than
reimbursed by the K30/K60 system (limited to 60 or 120 sessions depending on the
pathology).
The revenues are calculated using the full price of the K30/K60 nomenclature,
convention 9.50 and convention 7.71. The full price covers the reimbursement tariff and
the patient out-of-pocket payment. We used the tariffs that are applicable since January
2007. An overview of the tariffs applied to the five pathologies in the three (or less if
some systems are not applicable) reimbursement systems is provided in the Appendix
to chapter 10.
It should be noted that for some items in the protocol, no precise reimbursement tariff
could be identified. For example, if a patient gets one individual session of 2 hours and
one group session of 1 hour per day, this can only be charged to the RIZIV/INAMI as
one K60 (or R60 in convention 9.50), as centres can charge only one K60 per patient