Coordinated care pathway: authorised fee overruns of up to 17.5% at specialists consulted without referral by the GP

The order of 3 February 2005 approves the national agreement for general practitioners and specialists concluded on 12 January 2005 between the national union of health insurance funds and doctors' unions. Its fee provisions apply from 1 July 2005, when the coordinated care pathway centred on the referring doctor became operational. When a patient sees a specialist without referral by their referring doctor (non-coordinated access), the specialist may charge overruns capped at 17.5% of the tariff for each clinical act (rounded up to the euro) and technical act. The order of 28 July 2005 sets an equivalent surcharge for specialist outpatient consultations in hospitals without a referral.