The National Health Service is putting home and outpatient rehabilitation in order. New rules from 2026

The National Health Fund has presented assumptions for changes in the organization and financing of home and outpatient rehabilitation. As the Fund stresses, talks with representatives of the physiotherapist community on the necessary adjustments in this area have been going on for more than a year and are a response to the problems observed in the market for rehabilitation services.

One of the key challenges was the practice of providing home physiotherapy under outpatient rehabilitation contracts. The NFZ indicates that some facilities - instead of focusing on inpatient rehabilitation services - were using outpatient contracts mainly to provide home visits. This phenomenon, according to the Fund, generated high costs while limiting patients' access to outpatient rehabilitation.

The scale of spending on home rehabilitation is steadily increasing. In 2023, the value of these services amounted to PLN 1.4 billion, while in 2024 it was already PLN 1.8 billion. NFZ inspections have also revealed significant disparities between the number of personnel reported on contracts and the actual number of physiotherapists working in outpatient facilities, while mass provision of services in patients' homes.

One of the measures designed to curb these phenomena has been to increase the number of entities providing exclusively home rehabilitation. Within a year, their number increased from 591 to 694 nationwide, which, as the NHF points out, means that there are now facilities providing this type of service in almost every county.

The Fund has also taken steps to clean up the cost of rehabilitation services. As recently as 2023, the difference in the valuation of the same service provided in the patient's home, depending on the type of contract, was about PLN 25. In January 2024, these differences were reduced, and in the currently proposed solutions, the average value of rehabilitation services in the patient's home is to be the same, regardless of the type of contract.

Another problem highlighted by the NFZ is the provision of services outside the contract area. The Fund observes significant flows of entities between provinces, such as between Mazowieckie and Pomorskie or Łódzkie and Śląskie. There have been cases in which almost all services have been performed outside the county or even the province covered by the contract. In response, the NFZ announces that as of April 1, 2026, it will not fund home physiotherapy services performed outside the contracted province.

An important element of the announced changes is also the retention of the possibility of billing part of home rehabilitation under the outpatient contract. Although it was originally planned to completely separate the two forms as of January 2026, the NHF decided to leave the so-called "gateway", but to a limited extent. Until the end of 2025, the 50/50 rule applies, while from January 1, 2026, a maximum of 20% of staff time will be allowed for home services under the outpatient contract.

As the NFZ points out, "this is a compromise solution" to simultaneously safeguard the needs of patients requiring rehabilitation at home and increase the availability of services in outpatient clinics. Public consultations of the NFZ President's draft order ended on Wednesday, December 17, 2025.

Source: NFZ