Overview

• The HCAAM’s 2025 report puts specialists’ excess fees at €4.3 billion in 2024, rising about 5% per year in real terms since 2019 and likely to keep climbing.
• Sector 2 now accounts for 56% of specialists, up from 37% in 2000, with roughly three quarters of newly installed doctors choosing this status.
• Growth reflects higher surcharge rates and fewer acts billed at the official tariff, reducing the share of care at regulated prices.
• Patients face sizable bills despite help from complementary insurers that cover about 40% of excess fees on average; for hip replacements, nearly half pay surcharges averaging €630, topping €1,000 in 10% of cases.
• Assurance maladie is pressing to rein in surcharges as part of savings efforts, with scrutiny of sectors seen as earning economic rents such as radiology.