Andorra Raises Patient Fees for First Consultations to €9.60 for Specialists

The Andorran government has approved updates to CASS healthcare tariffs, raising patient contributions for first consultations with referring doctors and specialists while introducing a pilot programme for complex chronic patients.

Effective 1 September, the first visit to a referring doctor will total €34.41, with patients paying €8.60. Initial specialist consultations will cost €38.67 overall, requiring a €9.60 patient share. These rates will also apply if no consultation with the same professional has occurred in the prior seven years. General practitioner visits will rise by 1% to €31.41, with patients contributing €7.80.

Health Minister Helena Mas explained that first visits demand greater dedication due to their complexity and responsibility. The changes seek to better match compensation to clinical demands, support staff recruitment and retention, and reinforce referring doctors' role as the primary care entry point.

The pilot for complex chronic patients, launching 1 September at the Andorra la Vella primary care centre, will run for 12 months and involve up to 70 patients with multiple pathologies, advanced illness, or high emergency use. Each will receive an individualised, shared intervention plan covering follow-up, health education, caregiver support, and early decompensation detection. Participating referring doctors—estimated at 15 to 20—will coordinate with nursing, internal medicine, and other SAAS professionals. Standard visits remain 75% CASS-funded and 25% patient-funded, but the Health Ministry will add €31.41 per consultation to cover coordination without extra patient costs.

From 1 October, priority pathways will streamline to reduce unnecessary tests. Nurses gain authority to order diagnostics, prescribe medications and sanitary products, and refer patients within defined protocols—for instance, directing diabetic foot cases to podiatrists or screening for STIs. Specialist referrals extend from 12 to 18 months to cut paperwork and suit longer-term monitoring.

These steps follow State Health Pact guidelines, prioritising patient care and professional retention.