Circumcision Belgium reimbursement rules 2026

Health insurance maintains its fundamental principle: the operation is only covered if it responds to genuine clinical necessity. However, as indicated by INAMI, the practical procedures are changing from the beginning of June to ensure compliance with legislation. Doctors are still not required to request prior authorization from the health fund, but they must imperatively compile a comprehensive medical file. The latter must compile evidence of diagnosis, such as photographs, imaging examinations, microbiological analyses, or an anatomopathological report. These documents will remain available to the authorities for any subsequent verification.

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The main novelty targets boys under six years old. For this age group, the practitioner must mandatorily send a standardized notification form to the medical advisor before operating. Without receipt of this official document detailing diagnostic observations, the organization will refuse any reimbursement to families. From an accounting perspective, this pediatric intervention is subject to specific billing via the new code 262614-262625.

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For patients aged six and over, the procedure differs slightly. Billing is carried out under the nomenclature 260934-260945, replacing the previous single billing. If the submission of a prior form is not required in this case, the obligation to maintain a rigorous supporting file remains intact. The health fund and INAMI control services reserve the right to inspect a posteriori the medical validity of the act to authorize its reimbursement.