Amendment 21 for speech and language therapists: everything that changes in 2026
Amendment 21 for speech and language therapists: signed on 23 July 2025, in force on 23 February 2026. Timeline, end of the DAP for renewals and new billing rules.
Countries covered : France
Amendment 21 to the national agreement for speech and language therapists is the most significant reform of the year for the profession: abolition of the DAP for renewals, new flat-rate fees and adjustments to several billing rules. This page serves as an entry point and links to our detailed guides.
The timeline of Amendment 21
What changes in billing
Amendment 21 does not change the value of the AMO billing unit. It adjusts the coefficients of several assessments, shortens the minimum duration of some sessions and creates new flat-rate fees, for example for regulation work and interventions in schools. Rather than reproducing the grid here, please refer to our page dedicated to AMO/NGAP billing, which details the billing unit value, the coefficients per assessment, and the calculation method for billing.
The end of the prior authorisation request
The prior authorisation request (DAP) is disappearing for renewal assessments and treatment series extensions: checks now take place retrospectively. The quality of the reassessment thus becomes the practitioner's best protection. For the expected structure, comparison with the initial assessment, and traceability of transmission to the prescriber, see our page on the reassessment.
Downloadable summary of Amendment 21
Key measures on one page: DAP, rates, new possibilities. Access the PDF by entering your email:
What this means for your written reports
With retrospective checks, your assessments and your traceability are your best defense. Start with a fixed template (with comparison to the initial assessment for renewals), standardise your phrasing, and dictate right after the session.
This is exactly what Delta does: you capture your observations through live note-taking or post-session dictation, and the tool generates your structured assessments according to your template, with a longitudinal patient memory that reuses the objectives of the initial assessment. HDS certified hosting, GDPR compliant.
Frequently asked questions
When was Amendment 21 signed and when does it apply?
It was signed on July 23, 2025, and its measures came into force on February 23, 2026.
What happens to the AMO billing unit under Amendment 21?
It does not change. The AMO billing unit has been €2.60 in mainland France (€2.72 in the DOM) since 26 January 2024, before Amendment 21. The TMO billing unit (telehealth) has been €2.50 in mainland France (€2.62 in the DOM) since the same date. Details of the billing codes can be found on our page dedicated to AMO/NGAP billing.
Is the DAP abolished?
Yes, for renewal assessments and treatment series extensions. Checks now take place retrospectively; see our page on the reassessment.
Further reading
- Prescribing by speech and language therapists: what changes under France’s 2026 order
- Direct access to speech and language therapists: where do we stand in 2026?
- Speech and language therapy assessment: report (template)
- Delta, session notes and reports for speech and language therapists
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