What is Immediate Direct Payment?
Immediate Direct Payment (PID — Paiement Immédiat Direct) is a CNS scheme that allows the practitioner to be reimbursed directly and immediately by the CNS, without patients having to pay upfront. In practice:
- The patient pays nothing at the consultation.
- The practitioner submits the reimbursement request to the CNS via approved software.
- The CNS pays the practitioner directly at the agreed rate.
The PID payment flow
Consultation
→
Sigmund sends PID request to CNS
→
CNS reimburses practitioner
→
Patient: no upfront cost
CNS approval 2024: Sigmund received CNS PID approval in 2024, following a rigorous certification process. It is the only software dedicated to mental health professionals in Luxembourg to hold this approval.
Who can benefit from PID today?
Psychiatrists — available now
All CNS-contracted psychiatrists can activate PID. The option is available in Sigmund at €45/month in addition to the base subscription. This is currently the only mental health profession for which PID is operational in Luxembourg.
Psychotherapists — PID is coming soon
The CNS is actively working to extend PID to recognised psychotherapists, following the introduction of psychotherapy reimbursement in 2023. No exact date has been announced yet, but the rollout is underway.
Good news for Sigmund subscribers: as soon as the CNS opens PID to psychotherapists, Sigmund will activate it automatically in your account. No additional steps will be required on your part — you will be among the first to benefit from it.
Psychologists
The PID scheme does not apply to psychologists under the current Luxembourg regulatory framework.
The concrete benefits of PID
For the practitioner
- Zero CNS bad debts: the CNS pays you directly, eliminating non-payment risk on the reimbursable portion.
- Better cash flow: reimbursements arrive quickly and predictably.
- Simplified accounting: fewer reminders to manage, less tracking of individual payments.
- Competitive advantage: patients prefer practitioners who do not require upfront payment.
For the patient
- No upfront costs at the consultation.
- No administrative steps: the practitioner (via Sigmund) handles everything.
- Easier access to care, particularly for patients on lower incomes.
How Sigmund manages PID
Sigmund automates the entire PID process in the background:
- Record the consultation — enter the session in Sigmund as usual: date, patient, CNS act code.
- Automatic generation of the PID request — Sigmund formats and prepares the request in compliance with CNS requirements.
- Secure transmission to the CNS — the submission is encrypted and secure, sent directly from Sigmund.
- Dashboard tracking — view the real-time status of each request (pending, approved, rejected).
- Automatic reconciliation — reimbursements received are matched to the corresponding consultations.
Confidential export included: as with standard CNS invoicing, Sigmund generates an export of your fees without patient names, suitable for your Luxembourg income tax return.
PID and CNS invoicing: what's the difference?
PID does not replace CNS invoicing — it complements it. In both cases, you issue an invoice in CNS format. The difference is who pays the practitioner:
- Standard CNS invoicing: the patient pays the practitioner, then claims reimbursement from the CNS. The practitioner manages unpaid invoices and reminders.
- With PID: the CNS pays the practitioner directly. The patient pays nothing. The practitioner only invoices any fee excess above the CNS rate.
For more detail on CNS invoicing, see our complete guide to CNS invoicing in Luxembourg.
Frequently asked questions about PID
Is PID mandatory for contracted psychiatrists?
No, PID is optional. You can continue billing in the standard way (patient pays upfront) and activate PID whenever you choose. Once activated in Sigmund, the system handles everything automatically.
How quickly does the CNS reimburse via PID?
CNS reimbursement timescales via PID are generally shorter than with standard invoicing. Contact our team or the CNS directly for current processing times.
What happens if the CNS rejects a PID request?
If a request is rejected, Sigmund notifies you immediately in your dashboard with the reason for rejection. You can correct and resubmit directly from the application. Our team is available to assist if needed.
Can I activate PID mid-subscription?
Yes, the PID option can be activated at any time from your Sigmund account. It is billed at €45/month in addition to your subscription, with no additional commitment. You can deactivate it at any time.
When will PID be available for psychotherapists?
The rollout of PID for psychotherapists depends on the CNS. No exact date has been announced yet, but the process is actively underway. As soon as the CNS opens it officially, Sigmund will integrate it automatically for all psychotherapist subscribers — no additional steps required on their part.
