Belgian Nomenclature reform update as of June 2026

The National Institute for Health and Disability Insurance (INAMI/RIZIV) launched the structural reform of the Belgian Nomenclature of healthcare services in 2019. The reform is organized into three phases, with the key aim to modernize the Nomenclature by clearly separating physician remuneration (the “professional component”) from the costs associated with running a medical practice (“practice costs”), thereby improving transparency and consistency in healthcare financing.

Phase 1, covering the restructuring and standardization of procedure descriptions, has been completed. Phase 1bis, focused on general and specific application rules, is expected to conclude in the third quarter of 2027. 

Phase 2, involving the development of relative value scales for medical services, is also in progress and scheduled for completion by the end of 2027. In June 2026, INAMI/RIZIV presented an explanatory note outlining the methodology used to estimate medical practice costs at a macroeconomic level. This work, developed in collaboration with the Belgian Health Care Knowledge Centre (KCE) and academic research teams, categorizes medical activities into clinical, automated, and technical-surgical acts to better reflect their cost structures. The note is intended to support negotiations and inform the development of relative value scales, although the estimates provided are not considered definitive.

Phase 3, which will involve tariff setting and formal negotiations with stakeholders, is planned for late 2027 and 2028.

Alongside these phases, operational testing is ongoing to ensure feasibility and data quality. Initial statistical testing has been completed, while a second, more technical testing phase is currently being conducted in selected pilot hospitals and is expected to conclude in late 2027. A national “dry run” of the new system is planned for 2028 ahead of full implementation.

Publication of the new Nomenclature is scheduled for October 1, 2028, with national deployment beginning on January 1, 2029. DRG-based payments for certain low-complexity procedures are expected to start at the same time, while the updated Budget of Financial Means (BMF 2.0) is planned to enter into force on July 1, 2029.

This news is just one of about 300 market access news and updates collected by our team in the premium subscription service MTRC Access Intelligence every week from more than 80 organizations. Access our paid service to stay on top of all developments, specifically for your products in Europe (reimbursement news) and globally (HTA news). Access is organized as an online Database and email alert formats. Contact us to get a free, six-week, no-obligation trial.