The midwife-led prevention check-up is a 30- to 45-minute conversation, open to people aged 18–25, 45–50, 60–65 and 70–75 and fully covered (100%) by French National Health Insurance (Assurance Maladie). The midwife bills it under code RDV, €30 (€31.50 in the overseas departments and regions, or DROM), with no extra fees, once per age bracket, and sends the Personalized Prevention Plan to the patient’s regular doctor (médecin traitant).
As obstetrician-gynecologists, we work with midwives every day. Their place in Mon bilan prévention, France’s national prevention check-up program, seems obvious to us: they care for healthy women at times of life when people are receptive to prevention. This page brings together what a midwife needs to know to offer, conduct and bill the check-up, and to fit it with gynecological follow-up.
The midwife-led prevention check-up: what is the regulatory framework, and for which patients?
The prevention check-up is defined by the decree (arrêté) of May 28, 2024 on the providers, content and billing terms of prevention appointments. Its providers are doctors, midwives, nurses and pharmacists. French National Health Insurance describes the program as “a time for discussion dedicated to health prevention,” open to insured people aged 18 to 25, 45 to 50, 60 to 65 and 70 to 75 inclusive, once per age bracket.
A full-fledged provider
Midwives are listed in the decree on the same footing as doctors, and French National Health Insurance has a dedicated page for them, “Mon bilan prévention par les sages-femmes.” Signing up is voluntary; it is done on sante.fr, the French public health information portal, with a CPS or e-CPS card (the French health professional smart card or its digital version), and it lists the practice in the directory of providers that patients consult. A decree of July 28, 2026 (published in the Journal officiel on August 2, 2026) replaces the 2024 text as of October 1, 2026, adding physiotherapists without changing the role of midwives.
Women — and men?
The French Public Health Code defines midwives’ scope of practice around women: preventive gynecological follow-up, contraception, pregnancy and the postpartum period, with some openings toward the partner in sexual health. The official check-up pages do not say whether a midwife can see a man; the EHESP platform presentation mentions “a midwife (for women).” Until this is clarified, we recommend reserving the check-up for women, which matches the practice’s patient base.
The four age brackets from a midwife’s practice
| Age bracket | Situations the midwife already encounters | Check-up topics |
|---|---|---|
| 18 to 25 inclusive | First contraception, STI screening, catch-up HPV vaccination, first pregnancy | Sexual health and contraception, mental health, addictions, sleep, vaccinations, entry into the coordinated care pathway |
| 45 to 50 inclusive | Gynecological follow-up, perimenopause, cycle disorders, contraception at the end of the reproductive years | Menopause and perimenopause, cardiovascular risk, tobacco and alcohol, physical activity, cancer screening, mental health |
| 60 to 65 inclusive | Postmenopausal gynecological follow-up, pelvic floor disorders | Cancer screening, cardiovascular risk, vaccinations, physical activity, hearing and vision, isolation |
| 70 to 75 inclusive | Seen less often, except when continuing long-standing follow-up | Fall prevention, undernutrition, cognitive function, medication review, isolation |
The first two brackets account for most of the opportunities: these are the women the midwife already sees.
How does the prevention check-up work with a midwife?
The check-up lasts 30 to 45 minutes and follows the three steps defined by French National Health Insurance: identifying individual risks from the self-assessment questionnaire, jointly prioritizing one or two topics, then writing the Personalized Prevention Plan (PPP). It includes neither a physical examination nor any routine laboratory test: it is a conversation, which clearly sets it apart from the gynecological follow-up visit.
Before: the self-assessment questionnaire
The patient completes the self-assessment questionnaire for her age bracket in Mon espace santé (France’s personal digital health record) or as a PDF from ameli.fr, ideally a few days in advance; the link is sent with the appointment confirmation, as we describe in the prevention check-up questionnaire. Without the self-assessment questionnaire, time is lost on risk identification at the expense of the action plan.
During: identify, prioritize, write
The risk-identification aid form structures the conversation: medical history, treatments, living situation, screenings and vaccinations. Next comes a moment midwives know well from childbirth preparation classes: choosing with the patient one or two topics she is ready to act on, rather than going through the whole list. The PPP sets out goals, actions, local resources and timelines; there is an official template for each age bracket, described in detail in the Personalized Prevention Plan. The patient leaves with her plan; the midwife keeps a copy.
How do you bill the midwife-led prevention check-up: code RDV, €30, no extra fees?
Midwives bill the check-up under procedure code RDV, the same as doctors. French National Health Insurance states it unambiguously on its dedicated page: the check-up “can be billed only once per person and per age bracket with the procedure code ‘RDV’,” “is paid €30 in mainland France and €31.50 in the overseas departments and regions” and “cannot be subject to any extra fees.”
| Billing item | Rule for midwives |
|---|---|
| Procedure code | RDV (same as doctors; RDI for nurses, RDP for pharmacists) |
| Amount | €30 in mainland France, €31.50 in the DROM |
| Coverage | 100% French National Health Insurance, with no upfront payment for the patient |
| Extra fees | None |
| Frequency | Once per person per age bracket, across all professionals |
| Additional procedure on the same day | Only one procedure, and only if a need was identified during the check-up (Art. 5 of the decree of May 28, 2024) |
The “once per age bracket” rule applies whichever professional carries it out: a patient who had her 18–25 check-up at a pharmacy cannot have it again with the midwife for the same bracket; we ask and check the shared medical record (dossier médical partagé) before starting. Codes, amounts and pitfalls by profession are gathered in billing and coding for the prevention check-up.
How does the check-up fit with gynecological follow-up and sexual health for 18- to 25-year-olds?
Among 18- to 25-year-olds, the midwife is often the first professional they consult on their own, for contraception or screening. The check-up extends this visit without replacing it: it broadens the focus to lifestyle habits, mental health, sleep and addictions, and helps them enter the coordinated care pathway.
What the check-up adds to the contraception visit
The contraception visit addresses a specific request; the check-up starts from the self-assessment questionnaire: tobacco, alcohol, cannabis, screens, sleep, diet, physical activity, mood, isolation. The program’s sexual health topics — contraception, sexually transmitted infections, HPV vaccination — are discussed without an examination: if a Pap test, a screening or a vaccination is indicated, it falls under a separate visit or an additional procedure, according to the rules above. Catch-up HPV vaccination is available from ages 15 to 26, a scope extended on December 19, 2025; cervical cancer screening starts at age 25. The priorities for this age bracket are described in detail in the prevention check-up at ages 18–25.
The regular doctor, the PPP’s first goal
Many young women have no registered regular doctor, or no longer have one. Helping them register one is a PPP goal in its own right: this is the doctor who will receive the plan and handle the follow-up. The check-up is also the time to identify psychological distress, common at this age, and to include the appropriate referral in the plan.
What role do perimenopause and cardiovascular risk play in the 45–50 check-up?
Between 45 and 50, midwives see women in perimenopause: irregular cycles, hot flashes, sleep problems, weight gain, fluctuating mood. The check-up puts these symptoms into a broader perspective — heart, metabolism, screening — and sets one or two concrete goals.
Menopause: inform and refer, without prescribing during the check-up
Menopause is one of the program’s topics. During the check-up, the midwife informs, reassures and refers: explaining the transition, identifying symptoms that affect quality of life, including a dedicated visit in the PPP if a treatment needs to be discussed with the regular doctor or the gynecologist. The check-up is not the place for individual treatment advice.
The cardiovascular turning point
Perimenopause coincides with a rise in women’s cardiovascular risk. Tobacco, blood pressure, weight, sedentary behavior and alcohol are the levers the check-up can prioritize; an identified risk factor warrants a referral to the regular doctor for an assessment, the reasoning behind which is explained in 10-year cardiovascular risk. The organized breast cancer screening program starts at age 50 (ages 50 to 74) and cervical screening continues until age 65: the PPP can record the date of the next screening. The key points for this age bracket are in the prevention check-up at ages 45–50.
What should be sent to the regular doctor, and through which channel?
The Personalized Prevention Plan and the risk-identification aid form “must be sent to the patient’s regular doctor, unless the patient objects,” French National Health Insurance writes on the midwives’ page. There are three channels: secure health messaging, uploading to the shared medical record in Mon espace santé, or giving the documents to the patient, who brings them herself.
Sharing the plan is what gives the check-up its reach: a screening or vaccination listed in the PPP does not go without follow-up if the regular doctor sees it. Conversely, if a doctor has already carried out the check-up, the midwife can draw on the PPP at the next gynecological visit, without repeating it. The rules on the doctor’s side are in the prevention check-up carried out by a doctor.
Do midwives need “Mon bilan prévention” training?
No. “No additional training is mandatory in order to carry out these check-ups as a provider,” French National Health Insurance states. Optional modules, free after registration, are offered by the French School of Public Health (École des hautes études en santé publique, EHESP) at formation.bilan-prevention.ehesp.fr, including a sexual health module and a motivational interviewing module. For a midwife experienced in supporting patients, the main benefit is formalizing a stance she already practices; details are in training for the prevention check-up.
How do you integrate the check-up into a midwife’s practice?
The check-up works in its own time slot, separate from the gynecological visit, with a self-assessment questionnaire completed in advance. There are many opportunities: the end of a contraception visit with an 18- to 25-year-old, the annual follow-up of a 45- to 50-year-old, flagging patients in your files who are entering an age bracket.
Three organizational habits
- Identify: list in your software the patients aged 18 to 25 and 45 to 50 with no check-up recorded, and offer it when they book an appointment.
- Prepare: send the link to the self-assessment questionnaire and remind patients to bring their list of medications and their vaccination record.
- Coordinate: in a multi-professional health center (maison de santé) or a health center, or within a CPTS (a local health professional network — communauté professionnelle territoriale de santé), sharing check-ups among providers avoids duplicates and supports the local prevention mission, described on the page Sokrate for CPTS.
Mistakes to avoid
Billing an RDV when the patient has already had the check-up for the same bracket; billing outside the age bracket, for example at age 26 or 44; turning the check-up into a gynecological visit with an examination; forgetting to send the plan to the regular doctor; multiplying goals instead of choosing one or two.
Key takeaways
- Midwives have been providers of the prevention check-up since the decree of May 28, 2024, with a dedicated ameli page; voluntary sign-up on sante.fr.
- RDV billing code: €30 in mainland France, €31.50 in the DROM, 100% French National Health Insurance, with no upfront payment and no extra fees, once per age bracket.
- The check-up is a 30- to 45-minute conversation with no routine examination; it complements gynecological follow-up without replacing it.
- Ages 18–25: sexual health, mental health, entry into the coordinated care pathway. Ages 45–50: perimenopause, cardiovascular risk, screening.
- The PPP and the risk-identification form are sent to the regular doctor, unless the patient objects; no mandatory training, optional EHESP modules.
How to organize this pathway with Sokrate
The Sokrate service lets patients prepare their prevention check-up in advance, with an adaptive online questionnaire whose structured summary reaches the professional before the appointment. The plan is signed by a doctor, a letter is sent to the regular doctor unless the patient objects, and a care coordination nurse follows up on referrals. Organizations that coordinate check-ups among several providers will find how it works on the pages Sokrate for health centers and Sokrate for CPTS; the general framework is outlined in the prevention check-up.