Nurses carry out the prevention check-up for people aged 18–25, 45–50, 60–65 and 70–75 on their own, from risk identification to the Personalized Prevention Plan (PPP). They bill it under code RDI, €30 (€31.50 in the overseas departments and regions, or DROM), fully covered (100%) with no extra fees; for home visits, travel expenses are added. The PPP is sent to the patient’s regular doctor (médecin traitant), unless the patient objects.
As doctors, we see the nurse-led prevention check-up as a concrete lever for Mon bilan prévention, France’s national prevention check-up program: nurses know the home, daily life and family circle of patients whom we, for our part, see for a few minutes in an office. This page is for self-employed nurses (infirmiers libéraux, or IDEL) and salaried nurses, and for the teams that organize the check-up with them.
Can a nurse carry out a prevention check-up on their own?
Yes. The decree (arrêté) of May 28, 2024 on the providers, content and billing terms of prevention appointments makes nurses full providers of the prevention check-up, on the same footing as doctors, pharmacists and midwives. The nurse conducts the three steps, writes the Personalized Prevention Plan, gives it to the patient and bills the procedure under their own code.
What the nurse does on their own
- Sign up for the program 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), which lists them in the directory of professionals offering the check-up.
- Identify risks using the self-assessment questionnaire completed by the patient and the risk-identification aid form.
- Prioritize one or two topics with the patient and write the PPP using the official template.
- Bill code RDI, once per person per age bracket.
- Send the PPP and the risk-identification form to the regular doctor, unless the patient objects.
French National Health Insurance (Assurance Maladie) does not mention any prior medical prescription for carrying out the check-up.
What remains the doctor’s responsibility
The check-up is not a medical consultation and does not make a diagnosis. When the risk review shows a need for a test, treatment or medical opinion, the nurse records it in the PPP and refers the patient to their regular doctor. Some prevention procedures fall within nurses’ own scope of practice, vaccination in particular, and can be offered as a follow-on to the check-up.
How does the nurse-led prevention check-up work, at the office or at home?
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, writing the Personalized Prevention Plan. It can take place at the nurse’s office, at a health center or at the patient’s home; the content is the same.
| Step | What happens | Official tool | Point to watch for the nurse |
|---|---|---|---|
| 1. Risk identification | Reviewing the self-assessment questionnaire with the patient, supplemented by the risk-identification aid form (medical history, treatments, screenings, vaccinations, living situation) | Self-assessment questionnaire by age bracket (Mon espace santé or PDF from ameli.fr); risk-identification aid form | Fill it in with the patient if they could not do it alone |
| 2. Prioritization | Jointly choosing one or two topics the patient is ready to act on | Topic sheets (tobacco, alcohol, physical activity, sleep, diet, screening, vaccination…) | Let the patient choose |
| 3. Personalized plan | Writing the PPP: goals, actions, local resources, timelines; giving it to the patient | PPP template by age bracket; map of prevention resources on sante.fr | One copy for the patient, one for the regular doctor |
What a home visit changes
At the patient’s home, the nurse has information no self-assessment questionnaire provides: tripping hazards on the floor, prescriptions piling up, what is in the fridge, whether family or friends are around. These observations feed into the risk identification, especially for 70- to 75-year-olds (falls, undernutrition, medication review, isolation); anything that calls for a medical opinion is referred to the regular doctor via the PPP.
How do you bill the nurse-led prevention check-up: code RDI, €30 and travel expenses?
The nurse-led prevention check-up is billed under procedure code RDI, at €30 in mainland France and €31.50 in the overseas departments and regions. It is fully covered (100%) by French National Health Insurance, with no upfront payment for the patient, and no extra fees may be charged. It can be billed only once per person per age bracket. When it is carried out at the patient’s home, travel expenses can be billed in addition.
| Billing item | Rule |
|---|---|
| Procedure code | RDI (nurse); RDV for doctors, 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 |
| Home visit | Travel expenses billable in addition to the RDI |
“Mon bilan prévention” nurse billing: two recurring questions
Can you bill an RDI during a care visit? Combining it with another procedure on the same day falls under the rules of the national agreement, which should be checked (see table). Has the patient already had the check-up with their pharmacist or doctor? The RDI cannot be billed for the same age bracket; the nurse’s role is then to support the implementation of the existing PPP.
How does the nurse-led check-up fit with the regular doctor, and what should be sent?
The Personalized Prevention Plan and the risk-identification aid form must be sent to the patient’s regular doctor, unless the patient objects. They are sent via secure health messaging, through the shared medical record (dossier médical partagé) in Mon espace santé, France’s personal digital health record, or by the patient themselves. The regular doctor then follows up on the points that require a prescription or medical follow-up.
Sharing the plan is built into the program
Sending the plan is part of the check-up: it ensures that the screening, vaccination or medical opinion listed in the PPP is picked up by a doctor. We describe in the prevention check-up carried out by a doctor how the PPP received is added to the patient’s record; the content of the plan is described in detail in the Personalized Prevention Plan.
When the patient has no regular doctor
This happens with 18- to 25-year-olds and with patients who have little contact with healthcare. The check-up is an opportunity to include registering a regular doctor in the PPP; uploading the plan to Mon espace santé means it can be found on the day a doctor is designated.
Working as a team
In a multi-professional health center (maison de santé), a health center or a CPTS (a local health professional network — communauté professionnelle territoriale de santé), the nurse-led check-up is organized with the doctors: jointly identifying eligible patients, dedicated time slots, returning the PPP to the regular doctor. The one-check-up rule means recording who carried it out, to avoid double billing of an RDI and an RDV for the same bracket.
Do nurses need “Mon bilan prévention” training?
No. French National Health Insurance states that “no additional training is mandatory” to carry out the prevention check-up. Voluntary online modules are offered by the French School of Public Health (École des hautes études en santé publique, EHESP) at formation.bilan-prevention.ehesp.fr, notably on motivational interviewing and brief interventions.
These techniques are at the heart of the second step of the check-up: helping patients choose for themselves the topic they will act on, rather than handing them a list of advice. Access conditions for the modules can be found on the platform.
In which situations is the nurse-led prevention check-up especially useful?
The nurse-led check-up shows its full value with patients the doctor’s office sees rarely or poorly: the older person cared for at home, the adult with little contact with healthcare, the young person without a regular doctor.
A 70- to 75-year-old cared for at home
A 72-year-old patient, seen three times a week for a wound dressing, has never had a prevention check-up. The nurse offers it to her during a dedicated visit, after giving her the 70–75 self-assessment questionnaire. The risk identification draws on what the nurse has observed for months: a rug in the hallway, a loss of appetite, four prescriptions from different prescribers. The two priority topics are fall prevention and medication review; the PPP is sent to the regular doctor via secure messaging, and travel expenses are added to the RDI.
A 45- to 50-year-old with little contact with healthcare
A 48-year-old man, with no medical follow-up for years, sees a self-employed nurse for a vaccination. The nurse notices he is eligible and offers the check-up at a separate appointment. The risk identification highlights smoking, a sedentary lifestyle and the absence of any screening. The patient chooses to start with physical activity; the PPP also includes making an appointment with a regular doctor to assess cardiovascular risk and start the screenings recommended at this age.
An 18- to 25-year-old without a regular doctor
A 21-year-old student has no regular doctor and does not feel a “check-up” is for her. At a health center, the nurse offers it as a time for discussion, not as an examination. Sleep, mental health and contraception are discussed; the priority chosen is sleep. The PPP is uploaded to Mon espace santé, along with the steps to register a regular doctor.
In health centers and CPTS
For a practice or organization, the nurse-led check-up makes it possible to offer the program to more patients without adding to the doctors’ schedules. How to organize it is described on the pages for health centers and CPTS; the guide CPTS and the prevention mission details how to track indicators.
Mistakes to avoid
- Billing an RDI for a patient outside the age bracket or who has already had the check-up for the same bracket with another professional.
- Doing the check-up “in passing” during care without dedicated time: the three steps and the PPP do not fit into a ten-minute visit.
- Not sending the PPP to the regular doctor: a topic identified without medical follow-up goes nowhere.
Key takeaways
- Nurses carry out all three steps of the prevention check-up on their own and write the Personalized Prevention Plan, at the four key ages (18–25, 45–50, 60–65, 70–75).
- RDI billing code: €30 in mainland France, €31.50 in the DROM, 100% French National Health Insurance, no extra fees; travel expenses added for home visits.
- Only one check-up per person per age bracket, whichever professional carries it out.
- The PPP and the risk-identification form are sent to the regular doctor, unless the patient objects.
- No mandatory training; optional EHESP modules on motivational interviewing.
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 is made available to the professional who carries out the check-up. 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. For a multi-professional practice, Sokrate offers shared tracking of the check-ups carried out and of the referrals arising from the PPP. The details are described on the pages Sokrate for health centers and Sokrate for CPTS.