The list provided for in Article L. 162-52 of the Social Security Code provides for common law coverage of medical telemonitoring activities with:
- specific remuneration for medical telemonitoring operators carrying out medical monitoring;
- remuneration for the digital medical device (DMN) for medical telemonitoring, and, where applicable, collection accessories.
In order to be able to benefit from the support associated with a generic medical telemonitoring line, the operators of the telemonitoring DMNs must have a code allowing the individual identification of the DMN and, where applicable, the associated collection accessories that it uses. . These codes also identify the operator as well as the indication of the class and chapter of the international classification of diseases concerned.
These codes are issued subject to the DMN’s compliance with the interoperability and safety reference systems provided for in article L. 1470-5 of the public health code, as well as with the minimum technical specifications described for the generic line.
The form enabling DMN operators to request such codes will be indicated as soon as the first generic lines have been entered.
This form should be completed for each request for payment of medical telemonitoring activity through a generic line of the medical telemonitoring list.
Reminder of the provisions in force
In accordance with Article R. 162-102 of the Social Security Code (CSS), the payment or reimbursement of a medical telemonitoring activity is subject to the operator obtaining codes allowing the individual identification of the digital medical device and, if applicable, of the associated collection accessories that it uses. For medical telemonitoring activities relating to a generic line, the code request is made by the operator electronically to the Ministers responsible for Health and Social Security.
It is also recalled, in accordance with Articles L. 162-48 and R. 162-73 of the CSS, that this reimbursement is subject to compliance with the conditions specified in the registration order for the generic line, concerning in particular the technical specifications minimum requirements that the related medical devices and, if applicable, the collection accessories, the indications, the special conditions of prescription, use and distribution must respect. If necessary, the reimbursement, wrongly, by the health insurance of DMN of telesurveillance not respecting these various conditions might give rise to the procedure of recovery of the undue amount provided for in article L. 133-4 of the CSS.
Who must report?
The operator is responsible for reporting and obtaining an A-TM code.
Reference texts
Article 36 of the LFSS for 2022 amended:
Section 11: Telemedical monitoring (Articles L162-48 to L162-57)
Application texts
- The Conseil d’Etat decree relating to the payment and reimbursement of telemonitoring medical activities
- The simple decree relating to the content of the declaration of medical telemonitoring activities to regional health agencies
