Reimbursement amounts and patient co-payments

The three numbers that matter

A tariff is what the service costs. A reimbursement is what the insurer covers. The patient share is the difference. Belgian nomenclature publishes all three, and publishes the reimbursement and the patient share twice over: once for people with the preferential regime, once for everyone else.

This API labels every amount with which of these it is, so the distinction survives the trip into your application.

The preferential regime

Certain beneficiaries are reimbursed at a higher rate. For a consultation with an accredited GP, that is the difference between paying €1.50 and paying €6.00 out of the same €33.74 tariff. Both figures are published, and both are returned.

Context-specific amounts

The same code can carry different amounts depending on context — inside a care trajectory, for a beneficiary with a global medical record, for patients up to 24. Each is a separate fee code with its own description, returned alongside the rest rather than collapsed into one number.