Your child has a fever on a Saturday night, your regular doctor is no longer available since 7 PM, and you hesitate to call an on-call doctor. Even before dialing the number, one question arises: how much will it cost? The fee for an on-call consultation depends on the time, day, and location where you are seen.
Since December 2024, the basic consultation fee for a sector 1 general practitioner has risen to 30 euros, which mechanically alters the final amount in an on-call situation.
On-call consultation: why the fee exceeds that of a standard visit
An on-call doctor does not charge a free price. They apply the conventional consultation fee, to which an additional charge set by the Health Insurance is added. This additional charge compensates for the practitioner’s availability outside of regular office hours.
The additional charge varies based on three specific criteria:
- The time slot: evening (8 PM – midnight), deep night (midnight – 6 AM), or early morning (6 AM – 8 AM), each time frame has its own supplement.
- The day of the week: a consultation on Sunday or a public holiday incurs a different surcharge than that of Saturday afternoon.
- The location of the consultation: a home visit costs more than a visit to the office or a medical house on call.
A detail that comparative tables often simplify: there are two distinct additional charge regimes. The first concerns doctors who consult outside of office hours without being registered on the on-call list. The second, more structured, applies within the framework of the Ambulatory Care Continuity (PDSA), with specific coding.
To delve deeper into the applicable pricing grid, you can consult the medical rates on the Santéducation website which details the amounts by time slot.
PDSA codes and surcharges: the scale that patients never see
When you receive your care sheet after an on-call consultation, you sometimes notice unusual abbreviations: CRD, CRN, CRM, or CRS. These codes correspond to regulated acts of the care continuity and determine the exact amount of the surcharge.
Here is what each code concretely means:
- CRS: regulated consultation on Saturday afternoon. The surcharge remains moderate.
- CRD: regulated consultation on Sunday or a public holiday. The supplement increases compared to Saturday.
- CRN: regulated consultation at the beginning of the night (8 PM – midnight). The fee rises significantly.
- CRM: regulated consultation in the middle of the night (midnight – 6 AM). This has the highest surcharge.
These PDSA codes provide surcharges that are higher than the simple “night” or “Sunday” supplements applied outside of care continuity. The difference can reach several euros, which explains why two consultations at the same time do not always cost the same depending on the doctor’s status.
In practice, a patient consulting on a Sunday morning in a medical house on call (regulated act CRD) will pay more than with a general practitioner who exceptionally opens their office on the same day without being registered in the continuity system.
Reimbursement of the on-call consultation by Social Security
Social Security reimburses the on-call consultation on the same basis as any consultation: 70% of the conventional fee for a sector 1 doctor, after deducting the flat-rate contribution. The surcharges related to the on-call service are also covered, but only at 70%.
The remaining charge therefore directly depends on your supplementary health insurance. A mutual insurance with a good level of reimbursement for routine care will cover the surcharge without difficulty. An entry-level plan will leave a residual charge, especially in the middle of the night where the surcharge is highest.
One point that patients often forget: the coordinated care pathway remains active in on-call situations. If you go through 15 or the telephone regulation before consulting, you are considered to be directed by the healthcare system. Your reimbursement is not penalized, even if you do not consult your regular doctor.
On the other hand, consulting an on-call doctor directly, without a prior call to the regulation center, can be interpreted as accessing outside the pathway. The reimbursement then drops to 30% of the base fee, which doubles or triples the remaining charge.
Home visit at night: the expense to anticipate
Having a doctor come to your home in the middle of the night combines two types of surcharges: the hourly surcharge (night or middle of the night) and the travel surcharge. The total can reach a significantly higher amount than a daytime consultation in the office.
Organizations like SOS Médecins, which handle a large share of home visits on call, apply conventional rates. Their fees follow the Health Insurance grid, but the accumulation of surcharges increases the bill. A home visit between midnight and 6 AM costs significantly more than a daytime consultation.
Before requesting a visit, ask yourself: can the patient go to a medical house on call? These facilities, open in the evening and on weekends in many urban areas, charge for an office consultation, without a travel surcharge. The savings are real, sometimes amounting to several dozen euros.
The revaluation of the basic consultation to 30 euros since December 2024 has mechanically raised the floor for all these acts. Each surcharge adds to this new base, making vigilance regarding the care pathway and the choice of consultation location even more relevant to limit the remaining charge.
