The Departmental Council of the College of Physical Therapists of Haute-Garonne has warned against proposed French government reforms to physiotherapy session reimbursements.
In a statement sent to regional newspaper La Dépêche du Midi on August 25, 2026, executive board members Thibault Biason, Noémie Taurand, Charlotte Cottin, and Laura Ducos stated that physical therapy should be viewed as an investment in public health rather than a financial burden.
Haute-Garonne is a department located in the Occitanie region of southwestern France, centered around its capital city of Toulouse. Healthcare coverage in the area is administered through France's national health insurance scheme, Assurance Maladie, while professional practice and regulatory standards for physical therapists are overseen by the departmental council of the Ordre des masseurs-kinésithérapeutes, known locally as CDOMK31.
The council issued its intervention following reports published by La Dépêche on August 24 indicating that the French government is considering revisions to reimbursement rates for physical therapy sessions as part of a broader structural reform of the profession. The board emphasized that it wanted to contribute additional perspective to a debate it described as essential for the future of patient care access.
Risk of shifting financial burden
The board members argued that a policy focused exclusively on cutting physical therapy costs underestimates how early rehabilitation prevents serious medical complications, maintains patient autonomy, and avoids far more expensive care down the road.
They pointed to a recent medico-economic study commissioned by the National Council of the Order, which quantified substantial potential savings from prompt access to physical therapy. The study focused on chronic long-term conditions, known in France as ALD, as well as musculoskeletal disorders and care for frail elderly individuals.
In cases of low back pain, early physical therapy intervention is estimated to save several thousand euros per patient over a five-year period.
Conversely, the board warned that delaying or restricting access to rehabilitation risks shifting financial burdens to more intensive care settings, ultimately increasing total costs for both Assurance Maladie and individual patients.
Warning over uniform session caps
The council expressed strong concern over patient access, stating that equal access to care is already insufficiently guaranteed across France. They urged negotiation partners and health authorities to preserve full care access for vulnerable demographics if payment structures or coverage models are altered.
The board specified that any funding reform must safeguard elderly patients, individuals living with long-term chronic illnesses, disabled people, and patients experiencing a loss of independence.
They warned that imposing a uniform cap on the number of reimbursed sessions without evaluating each patient's clinical situation would penalize the individuals who rely on physical therapy the most.
Savings through direct patient access
As an alternative to spending cuts, CDOMK31 pointed to an underutilized cost-saving mechanism: allowing patients direct access to physical therapists without needing a prior medical prescription from a doctor.
Direct access without a prior medical referral has been trialed in France since 2024 within coordinated care structures and is included among Assurance Maladie proposal targets for 2027.
The board cited realistic economic projections showing that expanding direct access nationwide could generate approximately 3 billion euros in total savings for French society, including nearly 1.4 billion euros in direct savings for Assurance Maladie.
They added that direct patient access has already proven its clinical and economic efficiency in numerous other countries where it is currently active, suggesting French public authorities should expand the model more broadly.
Geographic disparities in Haute-Garonne
The departmental council reaffirmed its commitment to high-quality care and equal geographic access across all territories, calling attention to stark regional imbalances within Haute-Garonne and the wider Occitanie region.
While the density of practicing physical therapists remains generally favorable around the Toulouse metropolitan area, rural parts of the department face significant disparities and persistent difficulty in accessing rehabilitation services.
The board concluded that future healthcare financing reforms must account for regional specificities to guarantee balanced, equitable care availability for both urban and rural populations.
