# Assisted Teleconsultation Billing: Nurses 2026 > Doctor €25, nurse TLL €12 / TLD €15: who bills what in assisted teleconsultation? Telecare, tele-expertise and equipment grants — 2026 guide for French nurses. [ Back to blog ](/en/blog) # Billing assisted teleconsultation by a nurse (2026) P Promotal MedConnect June 16, 2026 7 min read [Image: Billing assisted teleconsultation by a nurse (2026)] When a nurse assists a patient during a teleconsultation, one question comes up every time: who gets paid, and how? The answer fits in a single sentence — **two professionals, two separate billings** — but it requires keeping four concepts apart, because France's national health insurance (Assurance Maladie) treats them separately. This guide clarifies the billing and remuneration of [nurse-assisted teleconsultation](https://promotal-medconnect.com/teleconsultation-assistee) in 2026: the physician's amounts, the nurse's accompaniment codes, the telecare framework, tele-expertise, and equipment grants. One methodological note up front: the convention tariffs cited here may change through successive amendments; when in doubt, the references remain ameli.fr and the national nursing convention. ## Four concepts you must not confuse Before talking money, you need to fix the vocabulary. This is the heart of the matter and the source of most billing errors. - **Teleconsultation**: a remote consultation performed by a *physician* (or midwife). The patient may be alone. The physician bills the act. - **Assisted teleconsultation**: the patient is on video with a physician while a *nurse is physically present* to set things up, take measurements, perform the clinical exam, and manage the video. The physician bills the teleconsultation; in parallel, the nurse bills their own accompaniment act (amendment 6 to the nursing convention). - **Nurse telecare (télésoin)**: care delivered remotely by the nurse *themselves*, with no physician on video. The nurse is the professional who performs *and* bills the act (amendment 9). - **Tele-expertise**: a professional remotely requests a colleague's opinion, asynchronously and *without the patient*. Physicians and, since 2023, nurses and advanced-practice nurses can be requesters. Keep the structuring distinction in mind: in assisted teleconsultation, **a physician and a nurse act together**; in telecare, **the nurse acts alone**; in tele-expertise, **two professionals exchange without the patient**. ## The physician's side: what they bill The teleconsultation is billed by the physician at the same tariff as the in-person consultation of the same nature, reimbursed at 70% by Assurance Maladie within the coordinated care pathway. Concretely, a **general practitioner bills €25**; a **specialist bills €30 or more**, depending on their specialty and sector. The physician must respect the coordinated care pathway (with the usual exceptions: patients without a referring doctor, emergencies, minors, direct access to certain specialties, nursing homes, prisoners), use video (audio-only phone is excluded), obtain consent, and archive a report sent to the referring physician. Their teleconsultation activity is also capped at a share of their annual activity. ## The nurse's side: the accompaniment codes (amendment 6) This is where the nurse's added value lies. When a nurse assists the patient during a teleconsultation, they do not bill the physician's teleconsultation: they perform and bill their *own* accompaniment act, created by **amendment 6** to the national nursing convention. Two separate claims therefore go to Assurance Maladie for the same session — the physician's, and the nurse's. The accompaniment act is coded **according to where the teleconsultation takes place**. Two codes structure this billing: CodePlace of deliveryTariff **TLL**Dedicated / fixed location (nurse's office, multidisciplinary health home, etc.)€12 **TLD**At the patient's home€15 In other words: assisted teleconsultation performed in a dedicated location is coded **TLL at €12**; performed at the patient's home, it is coded **TLD at €15**. Practical points to know: video transmission is required, the patient must have given consent, and — because the nurse is physically present with the patient — this accompaniment is not subject to the remote-activity cap that applies to telecare. To structure this activity day to day, MedConnect's [telemedicine solution for nurses](https://promotal-medconnect.com/solutions/infirmiers) brings the connected devices and the video call together in a single workflow; our [complete guide to assisted teleconsultation for nurses](https://promotal-medconnect.com/blog-posts/teleconsultation-assistee-infirmier-idel-guide-2026) walks through a session step by step. ## Nurse telecare: a distinct act Telecare must not be confused with accompaniment. Introduced by **amendment 9**, telecare (code **TLS**) refers to care delivered remotely by the nurse *themselves*, with no physician on video: clinical monitoring after hospitalization for cardiac decompensation or COPD exacerbation, medication-adherence support, monitoring of a patient on insulin, or remote wound-dressing follow-up, for example. Unlike TLL/TLD accompaniment, telecare is not assistance to a medical consultation: it is the nurse who performs and bills the care. **The exact telecare tariff is indexed to the nursing key-letter and is subject to scheduled revaluations; refer to ameli.fr for the current amount.** One condition deserves emphasis, because it is often misunderstood: telecare requires the patient to be **"known"** to the nurse (or to a nurse in the same group), with at least one act in the series performed in person. There is *no* "12-month" prior-knowledge rule for nurse telecare: that delay belongs to the physician teleconsultation framework and must not be transposed to it. Video transmission is mandatory, a report is archived, and telecare activity is capped at a share of the nurse's activity. ## What about tele-expertise? Tele-expertise is an asynchronous act, without the patient, between two professionals. The **requester** — the one seeking the opinion, who may be a nurse or an advanced-practice nurse — bills **€10**, within a limit of **3 acts maximum per patient per year**. The **responder**, the physician who provides the opinion, bills **€25**. The patient is not present and the act is covered without out-of-pocket payment. Tele-expertise is an excellent complement to nurse accompaniment for securing a specialist opinion: see our [tele-expertise](https://promotal-medconnect.com/logiciel/teleexpertise) page and the dedicated [nurse tele-expertise guide](https://promotal-medconnect.com/blog-posts/teleexpertise-infirmier-definition-cotation-2026). ## Equipment grants: your kit can cost you €0 Act remuneration is only part of the equation. Assurance Maladie also supports nurses' equipment. Under the lump-sum modernization grant, two amounts can be combined each year: **€350/year** for the video-connection solution (video transmission) and **€175/year** for connected medical devices, declared during the annual campaign. On the physician side, the digital-equipment grant is being overhauled in 2026 (transition to a digital allowance); the exact amounts for physicians are not confirmed at this stage and should be verified with Assurance Maladie. Beyond these individual grants, **Regional Health Agencies (ARS)** fund telemedicine projects through the Regional Intervention Fund, via regional calls for projects; amounts and criteria vary from one region to another and are not a systematic individual grant. Within a [CPTS](https://promotal-medconnect.com/solutions/cpts) (coordinated primary-care community) project, this structural funding can, depending on the project, bring the net cost of equipment for the caregiver down to €0. That is the decisive **return-on-investment** angle: the MedConnect [teleconsultation kit](https://promotal-medconnect.com/mallette-telemedecine) starts from **€3,000 excl. tax**, and once you combine the annual lump-sum grants with ARS funding in a CPTS, the remaining cost can be sharply reduced, or even brought to zero. To map every source you can tap, see our [telemedicine financing](https://promotal-medconnect.com/financement-telemedecine) page and, for territory-wide projects, our piece on [rolling out teleconsultation in a CPTS](https://promotal-medconnect.com/blog-posts/teleconsultation-cpts-logiciel-coordination-infirmier-2026). ## Summary: who bills what SituationWho billsAmount Teleconsultation (general practitioner)Physician€25 Teleconsultation (specialist)Physician€30 or more Accompaniment in a dedicated location (TLL)Nurse€12 Accompaniment at the patient's home (TLD)Nurse€15 Nurse telecare (TLS)NurseSee ameli.fr (amendment 9) Tele-expertise — requester (incl. nurse)Requester€10 (max 3 acts/patient/year) Tele-expertise — responder (physician)Responder€25 Nurse equipment grant (annual)—€350/yr + €175/yr Well equipped and well financed, the nurse becomes a central player in access to care across their territory. MedConnect's [teleconsultation equipment](https://promotal-medconnect.com/materiel-telemedecine) and [software platform](https://promotal-medconnect.com/logiciel/plateforme-telemedecine), HDS-certified and GDPR-compliant, are built for exactly that role. ## FAQ ### Do both the nurse and the physician bill during an assisted teleconsultation? Yes. These are two separate acts for the same session: the physician bills the teleconsultation (€25 for a GP, €30 or more for a specialist) and the nurse bills their accompaniment act (amendment 6), depending on the location: TLL at €12 in a dedicated location, TLD at €15 at the patient's home. ### What is the difference between assisted teleconsultation and nurse telecare? In assisted teleconsultation, a physician runs the remote consultation while the nurse physically assists the patient; the nurse bills TLL (€12) or TLD (€15) depending on the location (amendment 6). In telecare (code TLS, amendment 9), the nurse delivers the care remotely themselves, with no physician on video. Telecare requires a "known" patient, with at least one act in the series performed in person — there is no "12-month" rule. ### Can equipment really cost €0? It depends on the project. The lump-sum nursing grants (€350/year for video connection, €175/year for connected devices) already cut the remaining cost every year. Within a CPTS, structural ARS funding can, depending on the project, bring the net cost of equipment down to €0. The MedConnect kit starts from €3,000 excl. tax. ## Related articles [ [Image: Nurse-Assisted Teleconsultation (IDEL): The Complete 2026 Guide] Nurse-Assisted Teleconsultation (IDEL): The Complete 2026 Guide 8 min read ](/en/blog-posts/teleconsultation-assistee-infirmier-idel-guide-2026)[ [Image: Nurse Teleexpertise: Definition, Framework and Billing (2026)] Nurse Teleexpertise: Definition, Framework and Billing (2026) 8 min read ](/en/blog-posts/teleexpertise-infirmier-definition-cotation-2026)[ [Image: Teleconsultation in a CPTS: software and nurse coordination] Teleconsultation in a CPTS: software and nurse coordination 8 min read ](/en/blog-posts/teleconsultation-cpts-logiciel-coordination-infirmier-2026) ## Discover our telehealth solutions [ Telehealth platform Video consultation, AI scribe, patient records ](/en/software/telehealth-platform) [ Telehealth cart Integrated diagnostic devices ](/en/telehealth-cart) [ Diagnostic equipment Connected ECG, stethoscope, dermatoscope ](/en/diagnostic-equipment) ### Ready to discover MedConnect? 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