Speech therapist: conditions of access and exercise in France

Verified 01 August 2024 - Legal and Administrative Information Directorate (Prime Minister), companies Directorate, Ministry of Health

  • Regulated Health Profession
  • Liberal activity
  • EPA Code : 86.90E / European Code :?
  • Social contributions : Urssaf
  • Retirement : CARPIMKO: titleContent
  • Health insurance : scheme of PAMC: titleContent.

Definition

Speech therapy involves preventing, evaluating, and treating disorders and communication difficulties and the language in all its dimensions (oral, written, etc.).

It comprises in particular the treatment of disorders of mathematical cognition, speech, voice and oromyofacial functions (articulation, swallowing, breathing, etc.).

Speech therapy also involves maintaining the function of communication and orality in degenerative and neuro-degenerative pathologies. It is also capable of providing learning in other forms of communication non-verbal to supplement or supplement verbal functions.

Example :

The speech therapist is involved in the treatment, among others, of the following diseases or dysfunctions: Alzheimer's disease, aphasia, autism, stroke, ENT cancers, dyslexia, dysorthography, illiteracy, deafness, trisomy 21, etc.

The speech therapist provides speech therapy rehabilitation to patients of all ages with congenital (hereditary), developmental or acquired disorders (diseases, accidents, etc.).

Speech therapy is accompanied by advice appropriate forclose personal contact.

It contributes in particular to the development and maintenance of autonomy, the quality of life of the patient and the restoration of his relationship with the language.

The professional exercise of the speech therapist requires in-depth knowledge of the French language in all its components.

The speech therapist provides care only on medical prescription (except in exceptional cases, such as a medical emergency, in which case a report is compulsory for the attending physician). It must therefore be agreed with the Health Insurance (CPAM).

The speech therapist exercises completely independence and full responsibility. It shall establish its own diagnosis and decides on speech therapy.

Access

The conditions of access differ according to whether the trader is a French national or an EU national (or EEE: titleContent and Switzerland)

EU or EEA national

Conditions differ depending on whether the professional wishes to practice permanently (also called free establishment) or on a temporary and occasional basis also called Freedom to provide services (LPS)

Permanent establishment

Speech therapists who come from an EU (or EEA) country, if they wish to practice in France permanently, must meet the following 2 conditions:

  • Request and obtain a authorization to practice to the commission speech therapists and validated by the prefect regional
  • Register to the Shared Directory of Healthcare Professionals (RPPS).
Application for a license to practice

In order to be able to apply for a license to practice, a European national must complete theone of the following conditions :

The conditions differ depending on the country of graduation :

  • EU or EEA State which regulation access to the profession: this European State must be certified as having a diploma or qualification
  • EU or EEA State which does not regulate access to the profession: you must attest to a diploma or speech-language pathology obtained in that European country and attesting to exercise of the profession in one or more of those countries during 1 year minimum full-time or part-time equivalent over the last 10 years
  • Third State (non-EU and EEA): must attest to diploma speech therapy in this country and that this degree be recognized in one of the European countries and certify theexercise of the profession during 3 years minimum in one of these countries European.

If he fulfills any of these conditions, he must then to prepare a dossier with supporting documents its diplomas and/orexercise speech therapy in one or more European countries (EU, EEA or Switzerland).

Please note

The vast majority of EU and EEA countries regulate access to and the practice of the profession of speech-language pathologist.

The documents to be attached to the file are as follows:

  • Completed application form for authorization to practice the profession. Each region has a form. The applicant can find the form on the Dreets website of the region.
  • Readable photocopy of a valid identity document on the date of submission of the file
  • Copy of the evidence of formal qualifications permitting the exercise of the profession in the country of acquisition
  • Where appropriate, a copy of the additional diplomas
  • All relevant documents proving continuous training, experience and skills acquired during the professional exercise in a European State or in a third State
  • Declaration by the competent authority of the European State of establishment, less than one year old, that no sanctions have been imposed. (Certificate issued by the order if it exists, the employer or the training institute)
  • A copy of the certificates issued by the authorities issuing the evidence of formal qualifications specifying the level of training and, year by year, the details and hourly volume of the courses followed and the content of the duration of the validated courses
  • If the applicant has obtained his diploma or practiced in a European country which does not regulate the profession: all relevant evidence justifying his having practiced the profession of speech-language pathologist in that State, full-time for 1 year or part-time equivalent to 1 year in the last 10 years.
  • If the diploma was obtained in a non-European country: recognition of the evidence of formal qualifications established by the authorities of the European country which recognized that evidence of formal qualifications. Such recognition must enable the beneficiary to exercise his profession there.
  • Certificate of single application for the submission of file
  • Letter of motivation
  • Grid with the 13 sectors of internships and the details of the hourly volume of internships per institution
  • Title of the study brief

Please note

The supporting documents for the dossier must be drawn up or translated into french by a translator registered with the French courts.

The file must be sent to the Dreets of the applicant's region, to service of the commission of speech therapists.

Compensation measure

The Committee of Speech-Language Pathologists, which examines each case, may decide that the diplomas and practice of the European applicant have significant differences from their equivalents in France.

They may then ask the person to do a compensatory training and/or a aptitude test.

The aptitude tests are written and oral, with practical exercises. The internship is supervised by a professional who validates or not his follow-up.

Once the compensatory measures have been implemented, the committee issues an opinion on whether or not to authorize the exercise of the applicant.

Answer from the commission and the prefect

The Committee of Speech-Language Pathologists shall deliver its opinion to the prefect which gives theauthorisation.

The prefect of the region acknowledges receipt of the maximum file 1 month after its reception if it is full. It then indicates the missing information and documents.

If the applicant does not receive a response 4 months after the file has been sent, it may consider it to be rejected.

In the event of a positive response, the beneficiary may pursue the profession under the same conditions as the persons holding the certificate obtained in France. The user must then register with the Shared Health Professional Directory (SPOR).

In the event of a negative reply, the applicant may appeal against that decision to the administrative court of the place of his residence.

Who shall I contact

The European citizen can use the Solvit online service if he considers that his rights have not been respected:

Submit a complaint to Solvit

Registration in the Shared Health Professional Directory (SPOR)

Every European national authorized to practice must register at the RPPS: titleContent prior to installation.

The RPPS number replaces the old one Adeli number.

The approach is free.

The healthcare professional keeps this unique identifier throughout his/her career, even in the event of a change of place of practice.

Registration for the RPPS triggers the creation of the CPS card (health professional card) and the preparation of future pre-informed care sheets that will be transmitted to the practitioner when he registers for the CPAM.

Registration to the RPPS is made via the following online service:

eRPPS Registration Portal (RPPS Registration Number) for Healthcare Professionals

Freedom to provide services (LPS)

Any European national who is established as a speech therapist in an EU country (or EEA and Switzerland) may practice in France on an occasional and temporary basis.

FYI  

The big one majority of European countries (EU, EEA and Switzerland) regulate the profession of speech therapist. However, if the applicant is established in a country that does not regulate the profession (training or practice), then he must provide proof of practice of the profession minimum duration 1 year full-time, or part-time equivalent over the last 10 years in this country.

Speech therapists from EU or EEA countries must perform a statement accompanied by supporting documents.

The declaration shall include information relating to civil status, nationality, initial training, professional experience and lifelong learning validated by a competent body, linguistic knowledge, the legality of establishment in the European State of origin or the European State from which the foreign national comes, the absence of any prohibition, even temporary, on practicing, professional qualifications, professional insurance and the place of performance of the first supply of services and the list of supporting documents accompanying it.

The declaration must be addressed to the regional prefect the desired place of exercise.

All intelligence must be requested from the Dreets of the region concerned, in the service of the recognition of professional health qualifications.

Before the first service, the prefect checks the applicant's declaration, including his professional qualifications.

If there is a significant difference between the applicant's qualifications and those required in France, he may ask for a compensatory measure (aptitude test), however within a time limit of 1 month.

They also check their language proficiency level, based on the benefit requested.

FYI  

If the prefect does not carry out these checks within a period of1 month and does not notify the applicant of a reply within the same period, the European national may perform his first service. He must then use his professional title from the State of origin, so as to avoid any confusion with the French professional title.

The statement must be renewed annually.

The self-service speech therapist (LPS) does not need to register with the Shared Directory of Health Care Professionals (RPPS).

Please note

Partial access to the profession is possible if the acts of care can be clearly separated in the practice of the speech therapist.

National of France
Obtaining a Certificate of Proficiency in Speech Therapy (COC)

It is a university degree issued by the Ministry of Education.

The certificate of ability in speech therapy is obligatory to practice as a speech therapist.

Studies are carried out after obtaining the Baccalaureate.

The Speech-Language Pathology Certificate of Competency (COC) is obtained after 5 years post-graduate studies in one of the university training centers in speech therapy (CFUO). Each region has a CFUO.

Registration in the Shared Health Professional Directory (SPPD)

Anyone who fulfills the condition of diplomas must register at the RPPS: titleContent before starting to practice.

The RPPS number replaces the old one Adeli number. The health professional keeps it throughout his career, even if he changes his place of practice. Registration for the RPPS triggers the creation of the CPS card (health professional card) and the preparation of future pre-informed care sheets that will be transmitted to the practitioner when he registers for the CPAM.

The registration process for the RPPS is free of charge.

Please note

Records of professionals previously registered on Adeli are automatically transferred to the RPPS, by the end of 2024 for speech therapists. There is no need to resubmit an application. A table of correspondence between the two directories will be made available, making it possible to put each RPPS number in front of the last Adeli number known by the professional.

Registration to the RPPS is done by connecting to the following online service:

eRPPS Registration Portal (RPPS Registration Number) for Healthcare Professionals

Exercise

Step-by-step approach

The speech therapist may exercise his liberal activity under one of the following legal forms :

  • Individual business in the following order: the speech-language pathologist practices in his own name, he declares his turnover in non-commercial profits (NBC) and is subject to income tax (IR).
  • Business: the speech therapist exercises alone or with other associates. Creating an exercise business optimizes the tax burden by distributing revenue among partners. Options can reduce income tax (IR) or business tax (SI) and payroll taxes.

The collective exercise mode has several advantages, including the pooling of resources (computer equipment, personnel, premises, etc.).

It also allows the sharing of operating costs with the possibility of investing and making profitable the equipment.

It also offers greater comfort or flexibility in terms of working conditions or income.

If he wishes to practice in business, the speech therapist must choose one of the following forms :

  • SELARL (business of private practice with limited liability) or SELARLU (business of one-person private limited liability)
  • SELAS (simplified liberal share business) or SELASU (single-person simplified liberal share business)
  • SELAFA (Anonymous Liberal business)
  • SELCA (stock-sponsored liberal exercise business)
  • PCS (professional civil business), it allows several professionals to practice their profession together
  • SCM (civil business of means), it allows the pooling of means (personnel, material) with colleagues.
  • HIFIS (Interprofessional Outpatient business

Geographical area

Speech therapy is one of the health professions benefiting frominstallation aid in the underdensely populated areas, where thecare provision is under-represented.

The speech therapist can inquire about the Healthcare Professional Support Portal of its region. It notably has the zoning in force for speech therapists in the region concerned.

Healthcare Professional Support Portal

Regional Health Agencies (RHAs)

Pour en savoir plus

The speech therapist can also use the C@rto-santé tool to make a land survey prior to installation:

Cartosanté - Where to settle as a Liberal with a click

FYI  

There is also for speech therapists a aid to the modernization and tocomputerization of the cabinet professional. The methodological guide and the declaration of the indicators to be filled in to benefit from it can be found on the speech therapist's Amelipro account.

Support package for the modernization and computerization of the professional speech therapy practice

Ameli.fr

Pour en savoir plus

Accommodation space

The liberal activity may be exercised in a dwelling room. This may be the speech therapist's main residence or an independent space. Before doing so, it must be verified that the lease of a dwelling and the ownership rules do not prohibit the exercise of an activity.

The activity of the speech therapist involves receiving patients. You also need to get a assignment change authorization office with the mayor in the cities of more than 200,000 inhabitants, in Paris, as well as in the municipalities of the little crown of Paris.

The activity may also be carried out in office space :

  • Business premises or mixed-use premises (i.e. residential and business premises)
  • Subletting of premises already occupied by another trader.

Please note

Speech therapists may not settle in premises for commercial use or dependent on commercial premises. However, it may settle next to a health, social or medico-social or educational establishment, or a company providing care to its staff.

Speech therapists should contact the relations with the health professions of the sickness insurance fund (CPAM) of his place of practice.

He must inform the CPAM of his installation so that it can proceed with his registration and affiliation.

Following this step, the CPAM delivers to the speech therapist pre-identified care sheets, and possibly a stamp. CPS card assignment operations will also be enabled.

Finally, the sickness insurance fund informs him of his membership in the Medical Insurance Scheme for Practitioners and Licensed Medical Assistants (CMAP).

FYI  

As a Liberal, the speech therapist can sign up for a voluntary insurance against the risk ofaccident at work and occupational disease (AT/MP), as well as his collaborating spouse. That means filling out the form Application for admission to individual voluntary insurance for occupational accidents and diseases (PDF). It must be sent to the health insurance fund.

For theregistration at Urssaf, the speech therapist should consult the dedicated space on the website of theUrssaf.fr entitled “You are a medical practitioner and assistant ”.

From the date of commencement of activity, the speech therapist in liberal form pays social security contributions to the Urssaf, regardless of the mode of exercise. They are calculated on the basis of realized income (self-employed).

These contributions are must be paid online in one of the following ways:

  • Either every month. The monthly payment is made on the 5th of each month (or the 20th on option) by direct debit.
  • Either every quarter. The quarterly payment is made by direct debit, by electronic payment or by credit card. Contributions are payable for February 5, May 5, August 5, and November 5.

The speech therapist and his successors in title shall be subject to the CMAP scheme. Membership is made with the health insurance fund (CPAM) of its place of practice.

In addition to reimbursement of own care and amenities motherhood, invalidity or death, he shall also receive a old-age invalidity-death insuranceand insurance supplementary old age.

For more information on social security contributions: see Social protection for the liberal professional.

FYI  

Speech therapists cannot benefit from the micro-social scheme.

All speech therapists practicing in liberal bridge the obligation to take out professional indemnity insurance (CPR) before starting to practice.

The SPC guarantees damage caused to third parties (mainly patients) as part of the activity: choice of the wrong treatment, poor follow-up of the patient, etc. It offers support in the search for an amicable solution, support for legal and procedural costs, as well as compensation for the damage.

The speech therapist substitute is solely responsible for its mistakes, as is thestudent on internship. He is also required to take out insurance to cover his civil liability.

The businesses must also comply with this insurance obligation.

Please note

Damage to the health professional does not fall within the situations compensated by the CPR. This requires a specific legal protection (different from that for privacy).

Registration must be done online on the website of the company Formalities Office in the 15 days after the start of activity :

Company Formalities Window

This declaration informs all the organizations concerned by the launch of the speech therapist's activity (Insee, social organizations, Urssaf, public finance center...).

Insee shall assign a Siret number. This is a unique national identification number that identifies the establishment. It is composed of Siren (first 9 digits) which identifies the company and the Nic (last 5 digits) which is modified in particular when the address of the establishment is changed.

During the recording of the company (activity), Insee also attributes to the liberal speech therapist EPA code. For speech therapy activity, the APE code is 8690E.

This is the autonomous pension and provident fund for nurses, physiotherapists, pedicures, podiatrists, speech therapists and orthoptists.

It covers the compulsory contributions of retreat andinvalidity.

Membership is required.

It is automatic from the moment the trader has registered his activity as a self-employed liberal.

Affiliation takes effect on 1er the day of the calendar quarter following the start of business.

However, if, after one month of registration, the trader has received nothing from Carpimko, it is advisable to download and complete the following declaration and send it by post to Carpimko:

Carpimko: declaration of affiliation

Who shall I contact

  • Carpimko

    CARPIMKO

    Collections department

    The Quadrants

    3 Avenue du Center

    CS 50035

    78882 ST QUENTIN EN YVELINES Cedex

To find out more about membership of Carpimko, visit the following website:

Carpimko - Affiliation - I settle

CARPIMKO

Pour en savoir plus

In the event of failure to comply with this obligation, the trader shall be liable to a disciplinary sanction to the commission of speech therapists.

Every health care practitioner, including speech and language pathologists, should per 3-year period, follow a DPC route.

This training is obligatory.

This course combines 3 themes:

  • Training for further knowledge
  • Rating of professional practices through practice analysis
  • Risk Management.

A minimum of 2 actions on 2 themes different is required to fulfill its CPD obligation.

The National Agency for Continuous Professional Development (now ANDPC, formerly OGDPC) provides financial management for DPC actions.

This agency is in particular responsible for determining the conditions of compensation for liberal health professionals and contracted health centers participating in DPC actions.

For everything CPD information, the trader may contact the ANDPC:

Who shall I contact

  • National Agency for Continuing Professional Development (ANDPC)

    The Agency may be contacted:

    • By telephone: 01 48 76 19 05 (toll-free)
    • By email: infodpc@agencedpc.fr
    • By post: National Agency for Continuous Professional Development (DPC) - 93 avenue de Fontainebleau - 94276 Le Kremlin-Bicêtre Cedex

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