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74 Musculoskeletal & Neurological Rehabilitation KCE reports 57 5.1.5 Convention 9.50: Type convention – Institutions for ‘locomotor’ rehabilitation 5.1.5.1 Cost model 9.50 convention The cost of the rehabilitation activity, specified in the 9.50 convention is determined by the contract with RIZIV/INAMI and is equal for the 46 rehabilitation centres that subscribed to the 9.50 convention. The focus lies on the “new” 9.50 agreement that should have been applied since July 1st 2005, but only started August 1st 2006 (KB 22-06-2006). All sessions in the 9.50 conventions have to be multidisciplinary (at least 2 disciplines), in contrast to Knomenclature, which can also offer mono-disciplinary sessions. In the “new 9.50 convention” two rehabilitation prices are applied: • During the first 60/120 sessions (depending on the underlying pathology) a uniform price per rehabilitation session is paid. This is called R30/R60, where R30 stands for one hour and R60 for two hours of multidisciplinary rehabilitation activities (comparable to K30/60). The exact price is €30.58 for R30 and €61.15 for R60 (Oct. 2006) (comparable to the prices of K30/60, see further). • After these 60/120 sessions, the price per session is in relation to the underlying pathology, without any relation with duration of the session. • The accumulation of diagnostic with treatment honoraria or an accumulation of K-nomenclature with rehabilitation fees (9.50) is forbidden during the first 60/120 sessions (exception for speech therapy). After this first period one extra fee can be cumulated (e.g. Mnomenclature for physical therapy or R-nomenclature for speech therapy). Also, the “new 9.50 convention” cannot be preceded any more by K30/60, at least in the 46 existing 9.50 rehabilitation centres. Of course, centres without convention 9.50 can first apply Knomenclature, and then refer the patient to a 9.50 convention centre. The convention-centre receiving such a patient has to discount the amount of K-sessions already delivered from the 60 or 120 sessions they can deliver using R30/R60. A problem with regard to referral between different services is that after R30/R60, K30/K60 cannot be applied anymore in services without a convention. The price is subject to indexation.
KCE reports 57 Musculoskeletal & Neurological Rehabilitation 75 5.1.5.2 Target groups 9.50 convention Figure 5.10: Target groups convention 9.50 9.50 Group A2 - Acquired para or tetraplegia - Brain injury that causes severe neuromotor impairments or speech- and language impairments or other severe neuropsychological impairments Group A2bis - Chronic evolutive diseases of the brain and/or spinal cord, with motor or intellectual sequels, during the intensive rehabilitation phase after an episode of deterioration Group A4 - Amputation of an upper or lower limb Group B3 - Cerebral palsy - Congenital diseases of the spine and/or spinal cord - Dysmelia en phocomelia Group B4 - Myopathies: progressive hereditary muscular dystrophies, Thomson's myotonia congenita and autoimmune polymyositis - Mucoviscidosis - Severe musculoskeletal and psychological impairments due to rheumatoid arthritis in a Steinbrocker stadium III and IV Art. 5 paragraph 3 After the allowed maximal duration of a patient, there is a possibility to extend treatment with a more limited cost per treatment. Source: RIZIV/INAMI 2006 In Figure 5.11 the different pathology groups are linked to: • Maximum number of sessions (limited to one treatment per day) • Number of extra sessions that are allowed after the maximum number of sessions are reached • Maximum duration of the total rehabilitation program • Price of the session (€) after R30/60 • Maximum duration of the treatment interval (if specified)
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Dépôt légal : D/2007/10.273/19
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35. Etude relative aux coûts poten
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