Can a dentist charge for a missed appointment in Belgium?
A dentist in Belgium cannot bill a missed appointment, a no-show, as a treatment fee, neither to the patient nor to the sickness fund, because a fee pays for care that was actually given. What a practice can ask for is a reasonable compensation for the lost time, and only if the patient was clearly told the rule before the appointment, stayed away or cancelled too late without a good reason, and the amount stays below the fee for the treatment itself. There is no nomenclature code for a missed appointment, the sickness fund reimburses nothing, and the Dutch code C90 that turns up in searches does not exist here. No Belgian rule on this was written for dentists, so the reference point is the physicians’ code. This page is general information, not legal advice.
Tilcao is the operating system for dental practices in Belgium: its AI receptionist answers patient calls and WhatsApp messages in Dutch, French and English, and books, moves and cancels appointments in the practice’s own software, confirming and reminding so that fewer chairs sit empty.
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Fee or compensation: why the word matters
Because they are two different things, and only one of them is possible after a missed appointment. A fee, honorarium or ereloon in Dutch and honoraires in French, pays for a service. A compensation, schadevergoeding in Dutch and dédommagement in French, repairs a loss that somebody else caused. When the patient does not come, no service was given, so there is no fee to charge. What is left is the lost time, and a loss follows different rules.
The rule on fees is in the law, and it covers dentists directly. Article 35 of the coordinated law of 10 May 2015 on the healthcare professions gives dentists, like physicians, a right to fees for the services they have delivered. A missed appointment delivers nothing. That is why the real question is never whether you may invoice the consultation, but whether you may claim the time.
The difference has practical consequences, set out in the table. In short, a compensation never goes through the sickness fund, never comes with a certificate of care, and has to be justified by the practice rather than simply billed.
| Fee | Compensation | |
|---|---|---|
| What it pays for | Care actually given | Time lost because the patient did not come or cancelled too late |
| Nomenclature code | Yes, for a reimbursed service | None exists |
| Sickness fund | Reimburses its share if the service is covered | Reimburses nothing |
| Certificate of care | Issued | Not issued, because no care was given |
| What the practice must be able to show | That the care was given | That the patient knew the rule, was at fault, and that time was lost |
| If the patient was ill or had an emergency | Does not arise | Nothing should be asked |
What the physicians’ code says, and why dentists look at it
Belgium has no Order of Dentists, so no disciplinary body has written a rule for dental practices on missed appointments. The Order of Physicians has, and its wording is the most precise Belgian text on the question. It binds physicians, not dentists. It is still the yardstick a dental practice can hold its own policy against, and it is the text that the GBO, a union of general practitioners, and RTBF both quoted when the subject came up in 2024.
Two later advices from the same Order complete the picture, and both come back further down: one from November 2025 on keeping a compensation clause fair, and one from September 2026 on bank card guarantees. The core, though, is in its commentary on article 33 of the Code of Medical Deontology, which sets out five points.
- No fee may be charged for an appointment the patient did not keep.
- A reasonable compensation may be asked if the practitioner shows that the missed appointment caused a loss.
- The patient must have been properly informed beforehand of when such a compensation applies, for a no-show and for a late cancellation.
- The compensation must stay reasonable and may never reach the fee for the treatment itself.
- Special circumstances the patient can point to must be taken into account.
Does the sickness fund pay anything for a missed appointment?
No. The RIZIV/INAMI dental nomenclature, article 5, is the list of services a dentist can attest for reimbursement, and every entry in it is something done for the patient. We checked the version in force since 1 June 2026: none of its services is a missed appointment. So there is no code to use, no certificate of care to hand over, and no share for the sickness fund, the mutualiteit or mutualité, to pay.
That settles who pays. A compensation for a missed appointment is a private claim between the practice and the patient, paid in full by the patient, and it should be labelled as exactly that. Put it on a plain receipt as a compensation for a missed appointment, never as a consultation, and never on a certificate of care. Attesting a treatment that did not take place would be a false certificate. The physicians’ Order made the same point in an advice published in 1998: no certificate of care may be issued, because no service was given.
For a patient, the consequence is simple. If a practice asks you for a missed-appointment compensation, your sickness fund will not refund it, and the practice should have told you in advance what it is and when it applies.
Does the Dutch code C90 apply in Belgium?
No. C90, “niet nagekomen afspraak”, is a code used by dental practices in the Netherlands. Dutch pages about it show up in Flemish searches because the language is the same, and they often quote a percentage of the treatment price or a Dutch insurer’s position. None of that applies to a Belgian practice. The Netherlands has its own care authority, the NZa, its own insurance system and its own rules, and none of them reaches across the border.
C90 is not even an official Dutch treatment code. The NZa’s 2026 dental tariff decision lists its consultation codes from C001 to C023, and C90 is not among them. The NZa’s general position is that a no-show falls outside its tariff rules, because no care was delivered. So when a Dutch page tells you what C90 allows, it is describing a Dutch practice habit, not a rule, and certainly not a Belgian one.
Belgium has no equivalent code, as the section above explains. A Belgian practice that wants a missed-appointment rule has to write its own, in its own words, and tell patients before they need it.
What the patient must have been told, and where
The rule has to reach the patient before the appointment, in writing, in words a patient understands. A rule the patient first hears about on the bill is a rule you cannot rely on. Belgian patients already have a legal right to be told the financial consequences of care in advance, under the patient rights law of 22 August 2002. A missed-appointment compensation is not care, but it is money the patient may owe, and the physicians’ code asks for the same thing: tell them first.
The notice period is yours to choose. 24 hours is the common one, and it is the minimum recommended by the GBO, a Belgian union of general practitioners. Whatever you choose, use one number everywhere. A website that says 24 hours and a confirmation that says 48 is an argument waiting to happen.
Keep the proof. You need to be able to show three things: the appointment existed, the patient received the rule, and the patient neither came nor cancelled in time. The diary entry, the confirmation that was sent and a short note made on the day are the records to keep. As for where the rule should appear, there are four places, and the first matters most.
- The booking confirmation. It is the only place that shows this patient received the rule for this appointment. If the appointment was made by phone, confirm it in writing straight afterwards, with the rule in it.
- Your website and your online agenda, so that a patient booking online meets the rule before choosing a time.
- The reminder: one line with the notice period and the easiest way to cancel.
- The waiting room, as a poster. It reminds, but on its own it proves little, because it does not show that a given patient read it before booking.
Keeping the rule fair: reciprocity, illness and card guarantees
A missed-appointment rule that only ever works against the patient is the weakest kind. In November 2025 the physicians’ Order, relying on the Code of Economic Law’s rules on unfair terms, set out that a compensation clause must be clear, written in understandable language, reciprocal and proportionate. A clause is unfair, and therefore void, if only a late cancellation by the patient can lead to compensation, or if the amount clearly exceeds the loss the practice could suffer.
Those rules come from general consumer law rather than from medical ethics, so a dental practice should expect them to matter too. In practice it means writing the other half of the rule: what the patient is owed if the practice cancels at short notice without a serious reason. Your adviser can tell you what form that should take.
Illness, an accident, an emergency at home: the physicians’ code says special circumstances must be taken into account, and the 2025 advice says that where the absence is not the patient’s fault, nothing is owed. Write that exception into the rule itself. It costs nothing, and it is what makes the rest of the rule read as fair.
Do not make booking depend on a bank card. On 11 September 2026 the physicians’ Order called it unacceptable to make an appointment conditional on a prior card guarantee, because it can stand in the way of access to care and signals distrust of the patient. A patient who refuses to give one must still get an appointment. Dentists are not bound by that advice, but its reasons apply at a dental desk just as well.
A policy text and a waiting-room poster you can adapt
Below are two texts: a policy for your website, your online agenda and your booking confirmation, and a short poster for the waiting room. Replace everything in square brackets and use the same notice period in both. If your practice does not charge anything, delete the parts marked optional. A clear cancellation rule is worth publishing even without a charge, because it tells patients how and when to cancel.
You would not be the first. RTBF reported in May 2024 that physicians, dentists and physiotherapists increasingly post a rule of this kind in the waiting room: a missed appointment is charged unless it was cancelled at least 24 hours ahead, force majeure excepted.
Policy text for the website, the online agenda and the confirmation:
Missed and late-cancelled appointments. Your appointment time is reserved for you alone. If you cannot come, please let us know at least [24] hours in advance by calling [phone number], by writing to [e-mail address] or by replying to your confirmation or reminder. We will gladly offer you another time.
[Optional] If you do not come and have not let us know at least [24] hours in advance, we may ask you for a compensation of [amount] for the reserved time. This is not a treatment fee: your sickness fund does not reimburse it and no certificate of care is issued for it. We do not ask for it if you could not come because of illness, an accident or another circumstance beyond your control. If we cancel your appointment at less than [24] hours’ notice without a serious reason, [what your practice offers the patient in that case].
Poster for the waiting room:
Can’t come? Tell us. Please cancel at least [24] hours ahead by calling [phone number], by writing to [e-mail address] or by replying to your reminder. Your slot can then go to another patient who is waiting for an appointment. [Optional: An appointment missed without notice may lead to a compensation of [amount], not reimbursed by the sickness fund. Illness and emergencies excepted.]
On the amount, do not look for a Belgian figure, because none exists. If you set one, it is a fixed sum you choose in advance, it has to stay reasonable, and by the physicians’ yardstick it stays below the fee for the treatment that was planned. Check the wording with your professional association, such as VVT, VBT, the SMD or the Chambres de Médecine Dentaire, before you publish it.
A letter after a first missed appointment
What we recommend, and it is a recommendation rather than a rule: after a first missed appointment, send a kind message, offer a new time, restate the rule, and do not send a bill. A first no-show is often a forgotten appointment, and a friendly letter keeps the door open where an invoice may close it. If the same patient misses again, that is the moment to apply the policy you published, if you have one.
Send it the day after, in the channel the patient used to book and in the patient’s own language. Replace everything in square brackets.
Subject: your appointment of [date]
Dear [first name and surname],
We expected you on [date] at [time] for [type of appointment] with [practitioner], and you were not able to come. We hope everything is all right.
We would be glad to see you. We can offer you [first option] or [second option]. If neither suits you, reply to this message or call us on [phone number] and we will find another time together.
As a reminder, we ask all our patients to cancel at least [24] hours in advance, so that the time can be offered to someone who is waiting. [Optional: Our policy provides for a compensation when an appointment is missed without notice. We are not applying it this time.]
Kind regards,
[Name], for [practice name], [phone number]
Is charging worth it, and what reduces no-shows instead?
Rarely, if the goal is the money. A compensation for one missed slot is a small sum, the patient may dispute it, and a patient who refuses to pay can only be made to pay through the courts, which usually costs more than the slot was worth. A Flemish professional association for dietitians makes exactly that point to its own members: for a single missed appointment, most providers will never start a procedure. A published rule is still useful, mainly because it states the notice period and tells patients how to cancel.
Charging also costs goodwill. A practice that bills first and asks later can lose a patient over a single slot, and a lost patient costs more than the slot did.
What moves the number is the ordinary work set out on our page about reducing no-shows: a confirmation the patient can reply to, a reminder in the channel they actually read, and a waiting list that is called the moment a slot opens. The physicians’ Order said as much in 2023, when it named an accessible way to cancel and reminders before the appointment as effective tools against no-shows. A rule gives a late cancellation a deadline. The waiting list is what turns that cancellation into a filled chair.
Tilcao does that ordinary work and keeps out of the money. It does not invent or apply a missed-appointment fee. If your practice has a policy, the agent states it in your words when a patient books, confirms or cancels. If you have none, it says nothing about one.
Questions practices ask
Can a dentist in Belgium charge for a missed appointment?
Not as a fee, and not through the sickness fund. A dentist is paid fees for care actually given, and a missed appointment gives none. The practice can ask for a reasonable compensation if the patient was told the rule in advance, did not come or cancelled too late without a good reason, and the practice lost time it could not use. No Belgian rule on this was written specifically for dentists, so the physicians’ code is the usual reference, and the practice’s professional association is the place to check the wording.
How much can a practice ask for a missed appointment?
There is no Belgian figure, and this page will not invent one. A practice that charges sets a fixed amount in advance and publishes it. The physicians’ code says it must stay reasonable and may never reach the fee for the treatment itself, and under the Code of Economic Law an amount that clearly exceeds the possible loss is unfair. Keep it modest, put it in writing, and make the same rule work in the patient’s favour when the practice cancels late.
Does the sickness fund reimburse it, and is there a code like C90?
No to both. The RIZIV/INAMI dental nomenclature has no service for a missed appointment, so there is no code, no certificate of care and no reimbursement: the patient pays any compensation in full. C90 is a code used by Dutch practices, and it is not even in the Dutch care authority’s own 2026 dental tariff decision. A Dutch page quoting C90 does not apply in Belgium.
What should a dental no-show policy say?
Five things, in plain words. How much notice you need, often 24 hours. How to cancel, with a way that is easier than not turning up, such as replying to the reminder. Whether a compensation applies and how much, if you charge one. The exceptions, such as illness or an emergency. And what the patient is owed if the practice cancels at short notice. Put it in the confirmation, on the website and in the waiting room, with the same notice period everywhere.
I forgot my dental appointment. Can the dentist fine me?
Not a fine. A practice can ask for a compensation only if it told you the rule before the appointment, and it should not ask if you were ill or had an emergency. Your sickness fund will not refund it, and it should appear on a receipt as a missed-appointment compensation, not as a consultation. If you think the charge is unfair, tell the practice why you could not come.
Can a practice ask for a deposit or a card guarantee to prevent no-shows?
Think twice. On 11 September 2026 the Order of Physicians said it is not acceptable to make a medical appointment depend on a prior card guarantee, and that a patient who refuses to give one must still get an appointment. In 2023 it said that no agreement allows a physician to require a deposit as a condition for granting an appointment. Neither advice binds dentists, but the reasoning about access to care applies at a dental desk too, so ask your association before trying it.
Does Tilcao charge patients who miss an appointment?
No. Tilcao never invents a fee and never enforces one. If your practice has a missed-appointment policy, the agent repeats it in your words when a patient books, confirms or cancels, and if you have none, it says nothing about one. What it does do is make cancelling easy and offer the freed slot to your waiting list, which is where the time actually comes back.