Reimbursement of a medical consultation for a child under 16 years
Verified 22 October 2026 - Public Service / (Prime Minister)
The reimbursement of a medical consultation for a child under 16 years of age is subject to specific rules. Depending on whether the doctor consulted is a general practitioner, a pediatrician or a specialist, the amount and reimbursement of the consultation are different. In addition, there are specificities if you live in the overseas departments (Dom). Here we present you the regulations to know.
To find out what rates a healthcare professional charges, see the health directory on the Ameli website.
In metropolitan France
In metropolis, the reimbursement rate (70% from conventional rate) is identical for any child under the age of 16, with or without attending physician identified.
Reimbursement rules may vary depending on whether the child is seen by a general practitioner, pediatrician or specialist. Finally, the reimbursement of complex consultations and very complex may have specificities.
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General Practitioner
General practitioner consulted | Age of child | Price list | Basis of reimbursement | Amount refunded |
|---|---|---|---|---|
SSector 1 | Under 6 years old | €35 | €35 | €24.50 |
SSector 1 | From 6 to 16 years | €30 | €30 | €21.00 |
Sector 2 Adhering to the controlled pricing option (Optam) | Under 6 years old | Fees with controlled overruns (capped) | €35 | €24.50 |
Sector 2 Member of Optam | From 6 to 16 years | Fees with controlled overruns (capped) | €30 | €21.00 |
Sector 2 Not adhering to Optam | Under 6 years old | Free Fees | €28 | €19.60 |
Sector 2 Not adhering to Optam | From 6 to 16 years | Free Fees | €23 | €16.10 |
Please note
The mandatory consultations (8e day, 9e and 24e months) are reimbursed to 100%.
Pediatrician
Doctor consulted | Age of child | Price list | Basis of reimbursement | Amount refunded |
|---|---|---|---|---|
Pediatrician sector 1 | From 0 to 2 years | €40 | €40 | €28.00 |
Pediatrician adhering to the controlled pricing option (Optam) Sector 2 | From 0 to 2 years | Fees with controlled overruns (capped) | €40 | €28.00 |
Pediatrician sector 1 | From 2 to 6 years | €35 | €35 | €24.50 |
Pediatrician adhering to the Optam Sector 2 | From 2 to 6 years | Fees with controlled overruns (capped) | €35 | €24.50 |
Pediatrician sector 1 | From 6 to 16 years | €31.50 | €31.50 | €22.05 |
Pediatrician adhering to the Optam Sector 2 | From 6 to 16 years | Fees with controlled overruns (capped) | €31.50 | €22.05 |
Pediatrician not adhering to the Optam Sector 2 | Less than 2 years | Free Fees | €34.50 | €24.15 |
Pediatrician not adhering to the Optam Sector 2 | From 2 to 16 years | Free Fees | €23 | €16.10 |
Please note
The mandatory consultations (8e day, 9e and 24e months) are reimbursed to 100%.
Psychiatrist
Doctor consulted | Price list | Basis of reimbursement | Amount refunded |
|---|---|---|---|
Psychiatrist, neuropsychiatrist, neurologist sector 1 | €75 | €75 | €52.50 |
Psychiatrist neuropsychiatrist, neurologist adhering to the controlled pricing option (Optam) Sector 2 | Fees with controlled overruns | €75 | €52.50 |
Psychiatrist, neuropsychiatrist, neurologist sector 2 | Free Fees | €42.50 | €29.75 |
Complex and very complex consultations in the care pathway
To know the reimbursement rates of complex consultations and very complex, see the information listed on theHealth insurance.
In the Dom
The rules differ depending on the department:
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French Guiana, Martinique, Guadeloupe, Réunion
The rate of reimbursement by the Health Insurance for consultations for a child under 16 years is 70% the conventional rate.
Consultations with the doctor can be managed at 100% (e.g. if he benefits from the complementary health solidarity).
Please note
The reimbursement rate is identical for any child under the age of 16, with or without attending physician identified.
To find out the reimbursement rates for consultations or teleconsultations for children under 16, consult the information listed on theHealth insurance.
Mayotte
The rate of reimbursement by the Health Insurance for consultations for a child under 16 years is 70% the conventional rate.
Consultations with the doctor can be managed at 100% (e.g. if he benefits from the complementary health solidarity).
Please note
Children under the age of 16 are not covered by the flat-rate contribution €2.
To find out the reimbursement rates for consultations or teleconsultations for children under 16, consult the information listed on theHealth insurance.
Who can help me?
Find who can answer your questions in your region
If you depend on the general diet
French primary health insurance fund (CPAM)If you depend on the farm system
Agricultural social mutual fund (MSA)
Conventional relations between health insurance bodies and doctors
Complex and very complex consultations
Online service
National Health Insurance Fund (Cnam)
National Health Insurance Fund (Cnam)
National Health Insurance Fund (Cnam)
National Health Insurance Fund (Cnam)