This refers to procedures carried out by the following health professionals, either in private practice or as an employee of another practitioner:
- Midwives, when related to nursing care (code: AMI or AIS)
- Speech therapists (code: AMO)
- Orthoptists (code: AMY)
- Physiotherapists (code: AMS or AMK)
- Pedicurists (code: POD)
- Nurses (code: AMI or AIS)
All of these procedures require a prescription issued by a doctor.
The treatment form completed by the practitioner carrying out the procedure must be sent to the SPME, together with the prescription and/or the request for prior consent showing the SPME Medical Advisor’s decision.
Common treatment forms are now used by all social security schemes in Monaco (SPME, CCSS, CAMTI) and are distributed to contracted practitioners.
Prescriptions are valid for six months.
Prior consent of Medical Advisor
Procedures carried out by nurses and allied health professionals may be reimbursed provided that, in the case of certain procedures, including functional rehabilitation, nursing care, speech therapy and orthoptics…, the SPME, on the advice of its Medical Advisor, has agreed in advance to cover them.
All requests for prior consent should be sent to the SPME Medical Advisor.
Requests should include the original prescription issued by the doctor specifying the nature of the procedures, where they are to be carried out and the number of sessions to be completed (the last of these is not mandatory in the case of functional rehabilitation).
Requests should specify the following information:
- Full name and SPME registration number of the insured person
- Full name of the person receiving treatment
- Details of the health professional who will be carrying out the procedure
- Nature and code of procedures to be carried out and date of request
Treatment may not be provided until the SPME Medical Advisor has agreed to cover it, except in cases of medical emergency.
In all cases, prior consent from the Medical Advisor is valid for six months.