Doctors' fees

Kela reimburses part of the private doctor's fee and the examination and treatment charges according to a schedule of fixed charges.

Reimbursements of the costs of consulting a doctor in a private practice

Kela reimburses part of the fees charged by doctors practicing privately. The reimbursement rate is 60 %. Maximum limits on the reimbursable fees are specified in a schedule of fixed charges (only in Finnish). The treatment provided must be medically necessary for the reimbursement to be provided.

The maximum reimbursable fee specified in the schedule of fixed charges is often smaller than the fee actually charged by the doctor. However, the reimbursement is calculated on the basis of the fee actually charged if it is smaller than the fixed charge.

Reimbursement of examination and treatment charges

The costs of examinations and treatments prescribed by a doctor in private practice are reimbursed at a rate of 75 % of costs exceeding copayment (EUR 13.46 per visit) according to a schedule of fees (only in Finnish). Only one copayment is assessed for treatments prescribed at the same time, with the exception of physical therapy, where each session is subject to copayment.

The maximum reimbursable fee specified in the schedule of fixed charges is often smaller than the fee actually charged by the doctor. However, the reimbursement is calculated on the basis of the fee actually charged if it is smaller than the fixed charge.

Reimbursements are available for examinations and treatments to which you are referred to by a private doctor. These include

• laboratory and radiology tests
• psychological evaluations
• medical treatment
• chemotherapy
• physical therapy.

The treatment must be medically necessary and provided within 12 months of when the doctor gave you the referral. If your doctor refers you to a series of treatments, you can be reimbursed for up to 15 sessions.