Poland’s National Health Fund (NFZ) will implement changes to primary healthcare on May 1st, 2026, expanding diagnostic testing and offering financial incentives to clinics.
Expanded Diagnostic Testing in Primary Care
The NFZ is increasing the scope of diagnostic tests available through primary care physicians (POZ), aiming to reduce referrals to specialists. The changes, effective May 1st, 2026, broaden the range of covered services and increase funding for diagnostics.
Funding will range from 24.15 zł for basic tests to nearly 200 zł for echocardiograms, with clinics potentially earning up to 9,000 zł monthly for patient care.
Financial Incentives for Clinics
The increased diagnostic budget is intended to enable faster disease detection without lengthy specialist wait times. Clinics participating in coordinated care models can receive additional monthly bonuses, up to 9,000 zł.
This system aims to encourage proactive management of chronic conditions like diabetes, hypertension, and heart disease, potentially reducing the need for frequent specialist visits.
New Regulations for Non-System Patients
The NFZ is also revising billing procedures for patients not covered by standard health insurance, specifically those eligible for care under Article 112c of the Act on granting protection to foreigners on the territory of the Republic of Poland.
Specific fees are set at 135.20 zł and 60.08 zł for visits and vaccinations, respectively, providing clarity for clinics and ensuring access to care for eligible individuals.
Enhanced Prenatal Care Standards
The changes also incorporate guidelines from the Minister of Health’s regulations regarding the organizational standard of perinatal care. Special attention will be given to high-risk pregnancies with diagnosed fetal developmental defects.
Midwives in primary care will be authorized to conduct three additional prenatal education visits in such cases, and collaboration with psychiatric and psychological care providers is mandated.
NFZ Payment Rates for Primary Care Services
The following amounts are payments to healthcare providers (clinics and staff) and do not directly affect patient costs. They indicate which services the NFZ funds and how strongly it incentivizes their provision.
Key rates include 226.08 zł per capita for standard physician services, 228.36 zł for accredited physicians, 143.90 zł for preventative ChUK consultations, and various rates for tests and vaccinations (e.g., 40.04 zł for SARS-CoV-2/flu/RSV tests, 35.04 zł for HPV vaccination).
Implementation Timeline
The changes outlined in directive No. 48/2026/DSOZ came into effect the day after its signing and apply to services provided from May 1st, 2026. Clinics are required to adapt their IT systems to new reporting codes (e.g., code 5.01.00.0000281 for HIV tests).
