Nursing consultation: definition, content, documentation and reimbursement

The nursing consultation is now enshrined in law. The Act of 27 June 2025 provides that nurses conduct consultations and formulate a nursing diagnosis; the decree of 24 December 2025 defines its content, and an order of 26 June 2026 specifies the settings and documentation requirements. This guide explains what a nursing consultation is, how to conduct it, document it and, for private practitioners, how to secure reimbursement.

What is a nursing consultation?

It is a period of care that the nurse conducts independently, drawing on clinical reasoning, to assess a person's situation, identify their needs and implement a preventive or therapeutic approach within their remit. According to article R4311-3 of the Public Health Code, it is based on analysis of the person's situation and their environment.

Article L4311-1, as amended by the Act of 27 June 2025, states that nurses "conduct nursing consultations and formulate a nursing diagnosis".

Is a nursing consultation legal?

Yes. The Act amended article L4161-1 of the Public Health Code, which defines the unlawful practice of medicine: it does not apply to nurses who conduct nursing consultations under the conditions set out in the decree, nor to those who prescribe products and tests listed in article L4311-1. This decree was published on 24 December 2025. The order on acts and care of 26 June 2026 specifies that nurses are authorised to conduct these consultations independently within their areas of activity and competence.

What does a nursing consultation contain?

Article R4311-3 describes four components:

1. The clinical interview: observation, gathering and analysis of all information and clinical data necessary to assess the person's state of health.
2. The formulation of nursing care actions and objectives.
3. The delivery, evaluation or adaptation of nursing care, including where necessary the establishment of nursing prescriptions.
4. The organisation and coordination of interventions within the care pathway.

What tools are used?

The order on acts and care lists several tools available for consultation within the nurse's independent remit: nursing clinical examination, nursing interviews, identification and assessment of needs using standardised tools and scales, identification of psychological distress, malnutrition or fall risk, interpretation of laboratory results, rapid diagnostic orientation tests, motivational interviewing, development of an individual care plan.

What is a nursing diagnosis?

The decree defines it as the identification of health needs within the nurse's field of competence. It is the outcome of the clinical interview: it underpins care objectives, interventions and, where applicable, prescriptions. It is distinct from medical diagnosis; when the situation falls outside your remit, your role is to refer the person.

Key point: formulating a nursing diagnosis is the first of eleven domains of activity and competence for nurses listed in article R4311-2. It is no longer simply a pedagogical approach: it is now a regulatory competence.

Is a medical prescription required for a nursing consultation?

No. The consultation is conducted independently. The law provides that nurses participate in primary care within their independent remit, with direct access, and the decree allows them to take direct responsibility for patients for acts within their independent remit. Acts outside the independent remit that result from the consultation remain subject to prescription.

Where can a nursing consultation be conducted?

According to article 3 of the order on acts and care, anywhere nursing care is provided:

• in a healthcare facility;
• in a social care facility;
• in a private practice;
• at the patient's home;
• in any other structure authorised to provide nursing care.

How should a nursing consultation be documented?

The order requires that the nursing consultation be recorded by the nurse in the patient's file. The decree more broadly recalls that nurses initiate and ensure the documentation of nursing care in this file. In practice, your report should include:

• the reason for and context of the consultation;
• the data gathered and scales used;
• the nursing diagnosis or diagnoses;
• the objectives and actions agreed with the person;
• nursing prescriptions, which must also be recorded in the patient's file or shared medical record;
• referral and handover to other professionals.

For coordination, the order mentions the preparation of clinical notes for other professionals and liaison sheets.

Important note: a consultation that is not documented does not exist, either for continuity of care or in case of dispute. Write your report on the same day, in the file accessible to the patient's other carers.

Is a nursing consultation reimbursed in private practice?

For private practice, the order refers to the national agreement between self-employed nurses and the Health Insurance Fund to set the scope and conditions for reimbursement of consultations. Amendment 11 to this agreement, signed on 31 March 2026, creates according to the Health Insurance Fund an initial series of dedicated nursing consultations:

• supporting the initiation of insulin treatment in patients with type 2 diabetes;
• follow-up after a preventive health check at key life stages.

The amendment provides for further consultations at a later stage and creates the status of referral nurse for patients with long-term conditions. Fees and implementation dates are published by the Health Insurance Fund. For billing rules, consult our guide on NGAP and private practice billing.

What about the preventive health check at key life stages?

It covers medical history, lifestyle habits (diet, physical activity, addictions), prevention of chronic diseases, vaccinations and mental and social wellbeing; from age 60 onwards, it is based on the ICOPE programme, which assesses memory, nutrition, vision, hearing, mobility and wellbeing. Already open to nurses, it applies to people aged 18–25, 45–50, 60–65 and 70–75. It takes place in three stages: identifying risks, prioritising one or two topics with the person, and drawing up a personalised prevention plan sent to the GP. It is billed using the RDI code, once per person and per age group, with no additional charges; the fee is shown on the Health Insurance Fund's website.

Nursing consultation and advanced practice: what is the difference?

Any qualified nurse can conduct a nursing consultation within their field of competence. According to the Health Insurance Fund, amendment 11 also revalues the advanced practice nurse's session and reclassifies it as a consultation. The advanced practice nurse, meanwhile, practises with a specific qualification and expanded competences, particularly in prescribing and managing pathologies. See our guide on the advanced practice nurse, and for all your autonomous acts, the nurse's role and competences.

Official sources

• Légifrance: Act No. 2025-581 of 27 June 2025, Decree No. 2025-1306 of 24 December 2025 (article R4311-3), Order of 26 June 2026 setting out the list of acts and care (article 3), Order of 26 June 2026 on nursing prescriptions
• National Assembly: adopted text of the Act on the nursing profession
• Health Insurance Fund: Amendment 11 to the agreement for self-employed nurses, amendments to the national agreement, preventive health checks by nurses
• National Order of Nurses: publication of the Decree of 24 December 2025