Care performance model (ZPM)
As of January 2022, there is a new funding system for mental health care: the care performance model. This means that rates are determined depending on the setting, the treatment discipline, the type of consultation and the duration. The psychologists of POLARIS fall under quality statute section II. There are two types of consultations: diagnostics (intake and advisory interviews) and treatment.
In order to be eligible for reimbursement of the treatment, you must have a DSM-5 disorder. The treatment of the following complaints/problems is not reimbursed from the basic package: burnout, relationship problems and adjustment disorders. Treatment is possible in these cases, for which a separate rate applies.
Care demand typification
Part of the ZPM is the care demand typing. Based on the intake, the psychologist fills in a questionnaire in which the care needs and problems are determined. This leads to a care demand typification in the form of a code. In 2022 and 2023, this code must be stated on the invoice, but has no further influence on the rate of the treatment and/or the care offered.
Specialist mental health care and basic mental health care
Treatment can take place in specialist mental health care (SGGZ) or basic mental health care (BGGZ). This depends on the referral and the request for help. The rates are the same, but for BGGZ the number of sessions is limited.
To be eligible for reimbursement, you need a referral letter from your general practitioner.
The psychologists at POLARIS work without contracts with the health insurers. You agree with your psychologist whether you will receive an invoice per session or per month. You must submit the invoice to the health insurer yourself. Depending on your health insurance, you will be reimbursed 50-100%. Please check with your health insurance company in advance. You are responsible for timely payment to us. For treatment in mental health care, the deductible applies per calendar year (385 or higher).
If you wish, it is possible to pay for the treatment yourself. This means that no information is sent to the health insurer. The rates are equal to the rates of the insured care (and exempt from VAT).
Below are the most common types of consultations within POLARIS and the associated rates. An intake interview (diagnostics) lasts 60 minutes, a therapy session (treatment) lasts 45 minutes, unless otherwise agreed with you. This concerns the direct time (duration of the conversation), the indirect time for reporting, etc. is included in this rate. We use the (maximum) rates of the NZa. For a complete overview see: healthcare performance model.nza.nl
Diagnostics 60 minutes: 229.67
Treatment 45 minutes: 169.56
Treatment 75 minutes: 246.48
Diagnostics 60 minutes: 173.40
Treatment 45 minutes: 128.40
Treatment 75 minutes: 187.76
Peer consultation short: 22.18
Non-basic package care consultation: 117.33
Appointments can be canceled free of charge up to 24 hours in advance, after which 45 euros will be charged. The costs of a no show are not reimbursed by the health insurer.