From the September 21, 2026 the rates of hundreds of health services provided through the National Health Service are changing and, for those who have to undergo a specialist visit or an exam, the first question is inevitable: how much will the co-payment increase? The answer is less immediate than it might seem, because the new price list actually involves an increase in the amounts recognized for some services, with an average increase of around 5.8%, but this does not mean that each patient will find themselves paying 5.8% more at the counter.
The review concerns 448 specialist outpatient services and 222 prosthetic assistance codesfrom medical visits to diagnostic tests up to some procedures and devices intended for people with disabilities. The new decree in fact modifies the tariffs used by the National Health Service to remunerate public and accredited private structures, intervening on values that in many cases were considered no longer adequate for the costs incurred by the providers.
Rates and tickets are not the same thing
This is the most important distinction to understand what will happen from September 21st. The tariff establishes the value of the service within the healthcare system, while the ticket represents the amount that is actually requested from the citizen when he does not benefit from an exemption.
For specialist outpatient services, the Ministry of Health indicates as a general rule a ticket corresponding to the rate of the service up to maximum limit of 36.15 euros per prescriptionwithout prejudice to the exemptions and methods applied at territorial level. As a result, when the new rate exceeds that threshold, the entire increase is not necessarily passed on to the patient.
An example clarifies the mechanism well. There first cardiological visit with electrocardiogram goes from 33.60 to 38 euros. In a Region that applies the ordinary ceiling of 36.15 euros, however, a non-exempt citizen will not pay 38 euros: the payment will reach a maximum of 36.15 euros, with an effective increase of 2.55 euros compared to the previous rate.
Even more evident is the case offine needle aspiration of the breastwhose rate rises from 31.25 to 36.50 euros. Applying the same mechanism, the ticket would stop at 36.15 euros, with an effective increase of 4.90 euros and not 5.25.
Which visits increase from September 21st
For many of the first specialist visits the retouching is decidedly more limited and is around one euro. Various services that currently have a rate of 25 euros will in fact go to 26 euros: these include, for example, first neurological, gynecological, orthopedic, pneumological, endocrinological and gastroenterological visits.
The first eye examination takes place instead 25.80 to 26.80 euroswhile the dermatological or allergological one rises from 25.40 to 26.40 euros and the ENT one from 26.20 to 27.20 euros.
The adjustments also affect some very common diagnostic services. There simple spirometry goes from 24 to 24.90 euros, theelectrocardiogram from 11.60 to 12.05 euros and the venous sampling from 3.80 to 4.30 euros. Even in this case, however, the final bill will depend on the composition of the recipe and whether the maximum cost sharing limit has been reached.
Not everything increases: over eight out of ten performances remain stagnant
Speaking generically about an “increase in healthcare copayments”, therefore, risks giving a distorted image of the reform. According to the analyzes on the new tariff, in fact, over eight out of ten performances remain unchanged.
The specialist check-up visit, for example, remains at 17.90 euroswhile the chest x-ray does not change, remaining at 15.45 euros, the abdominal ultrasound at 37.80 euros, the gynecological ultrasound at 30.95 euros and the lumbar or femoral bone densitometry at 31.50 euros.
Many of the most frequently performed laboratory tests also remain substantially unchanged, from blood count to blood sugar, from glycated hemoglobin to cholesterol, up to triglycerides, creatinine, TSH and ESR. Among the operations related to blood tests, the adjustment concerns venous sampling, which increases by 50 cents.
First visit or check-up: a difference that can change the price
An element to pay particular attention to is the distinction between first visit and follow-up visitbecause the two services have different rates and do not simply depend on whether the patient has already been visited in the past.
The first visit can in fact also concern a new health problem, a different diagnostic question or a worsening of an already known pathology; the check, on the other hand, is part of the continuation of a process already started, for example to evaluate the results of prescribed tests, verify the response to a therapy or monitor over time a condition already taken care of.
With the new price list this distinction becomes even more important, because while many first visits increase, the general price for the check-up visit remains unchanged.
I have already booked a visit after September 21st: how much will I pay?
The change also concerns those who have booked a visit or exam in the past weeks or months but will have to carry out the service from September 21st onwards. In these cases, the rate in force on the day the service is physically provided may be applied, even if the prescription or booking is prior.
Those who already have an appointment, therefore, would do well to check the updated amount through the Cup, the electronic health record or the services made available by their Region, without automatically canceling or redoing the booking.
It is also advisable to check the service code on the prescription, the correct indication of the first visit or check-up, any exemption code and other elements that may affect the amount actually requested.
Those entitled to the exemption continue not to pay
The new tariff does not cancel the exemptions from the ticket provided for by the legislation. The benefits provided therefore remain in force, depending on the requirements, for income, chronic or rare pathologies, disability and other conditions established by law.
Furthermore, not all healthcare services are subject to co-pays. The Ministry recalls, among other things, that cost sharing is not foreseen for certain services included in organized screening programs, for the activities of the general practitioner and pediatrician of free choice, for services directly linked to hospitalization and for various services provided in situations of particular social interest.
Because rates change
The revision arises from the need to realign the remuneration of services to the costs actually incurred by healthcare facilities. The agreement reached at the State-Regions Conference foresees an impact on public finances of approximately 210.7 million euros per yearof which 183.1 million destined for outpatient specialists and 27.6 million for prosthetic assistance; for 2026 alone the commitment is estimated at approximately 70 million euros.
The objective is to make the provision of services through the National Health Service more economically sustainable, including those provided by accredited private facilities. This, however, does not automatically mean that from 21 September the waiting lists will also decrease: availability of doctors and staff, equipment, organization of agendas and capacity of individual structures remain decisive variables.
For citizens, therefore, September 21st does not mark the arrival of an indiscriminate increase in the health copay, but the entry into force of a new tariff system which in some cases will produce a real increase, in others it will be absorbed by the maximum cap per prescription and in the majority of services it will not lead to any change. The amount to be paid will also continue to depend on regional rules and the individual situation of the patient: and it is precisely for this reason that, especially for those who already have visits or tests booked after the new date, checking the updated cost in advance will be the easiest way to avoid surprises at the counter.
