Physiotherapy Netherlands: What Basic Insurance Covers and the 20-Treatment Rule

Prices, fees and rules in this article were checked on 28 October 2026. They can change, so check the linked pages before you decide.

Physiotherapy (fysiotherapie) and exercise therapy (oefentherapie) are only covered by Dutch basic health insurance for certain conditions, according to Zorginstituut Nederland, the government body that explains what the basic package covers. Children under 18 get more covered than adults. For most adults, physiotherapy is only paid from basic insurance if the condition is on the official list of chronic conditions, and even then you pay the first 20 treatments yourself. A few conditions, such as hip or knee osteoarthritis and COPD from stage II, are covered from the first treatment. Covered physiotherapy for adults also falls under the compulsory eigen risico. This guide sets out the rules so you can check your situation before your first appointment.

1. Physiotherapy coverage at a glance

Source: Zorginstituut Nederland, “Fysiotherapie en oefentherapie (Zvw)”, checked 28 October 2026.

2. Children under 18

For children, coverage depends on whether the condition is on the list of chronic conditions (lijst van chronische aandoeningen):

• On the list: treatments are covered from the first one. You decide with the therapist how many are needed. If the list gives a maximum treatment period, coverage stops when that period ends.
• Not on the list: 9 treatments are covered over a period of one year, starting on the day of the first treatment. If the result is not sufficient, up to 9 extra treatments in that year are covered. You agree with the therapist how to spread them over at most 12 months.

Zorginstituut Nederland explains what happens at 18. If a child starts treatment for a listed chronic condition at 17 and continues after turning 18, everything from the 20th treatment is covered; if fewer than 20 treatments have been given, the remaining ones up to and including the 20th are paid by the patient. For conditions not on the list, coverage stops at 18, even if fewer than 9 treatments were used.

3. Adults: conditions covered from the first treatment

For adults, Zorginstituut Nederland lists these conditions for which physiotherapy or exercise therapy is covered from the first treatment:

• Pelvic physiotherapy or exercise therapy for urinary incontinence: up to 9 treatments in one year from the first treatment.
• Claudicatio intermittens (narrowing of the leg arteries, sometimes called “window-shopping legs”, etalagebenen): supervised walking training, up to 37 treatments in one year.
• Osteoarthritis of the hip or knee: up to 12 treatments in one year.
• COPD from GOLD stage II: since 2025, all exercise therapy treatments are covered from the first treatment, with no maximum. COPD stage I is not covered.
• Rheumatoid arthritis with severe functional limitations: covered since 2025, with no fixed maximum number of treatments.
• Axial spondyloarthritis (axSpA, formerly Bechterew’s disease) with severe functional limitations: long-term supervised exercise therapy for patients aged 18 or older, with no fixed maximum.

For the conditions with a maximum, the year starts at the first treatment, and you agree with your therapist how to spread the treatments over at most 12 months.

4. Adults: the chronic conditions list and the first 20 treatments

If you are 18 or older and your doctor has established that your condition is on the list of chronic conditions, treatments can be covered from the 21st treatment. You pay the first 20 treatments yourself. After that, treatments are covered as long as you need them given your complaints and limitations, unless the list sets a maximum number of months.

Zorginstituut Nederland notes that for most conditions on the list, the length of the treatment period does not matter, even if it lasts many years, as long as the need is substantiated. For some conditions the treatment period is limited, usually to 12 months from the first treatment. The full list is in annex 1 of the Besluit zorgverzekering; your insurer or therapist can tell you whether a maximum period applies.

If your complaint is not on the list and not one of the conditions in section 3, basic insurance does not cover physiotherapy.

5. Eigen risico, own payments and supplementary insurance

• Eigen risico. Physiotherapy and exercise therapy covered by the basic package fall under the compulsory eigen risico. The Rijksoverheid states that this is €385 in 2026, and that children under 18 pay no eigen risico.
• No own contribution. There is no separate own contribution (eigen bijdrage) for treatments that are covered.
• Treatments you pay yourself. For listed chronic conditions you pay the first 20 treatments. Any treatments beyond what is covered are also for your own account.
• Supplementary insurance. Zorginstituut Nederland says extra treatments may fall under a supplementary policy (aanvullende verzekering); check your policy.

Our health insurance 2027 guide explains the eigen risico and the period for switching policies.

6. Referrals and contracted physiotherapists

Zorginstituut Nederland points out two practical conditions:

• Referral. For your insurer to pay, you sometimes need a referral from your GP (huisarts) or specialist. Check your policy first. Our huisarts guide explains how to register with a GP.
• Contracted therapist. Choose a physiotherapist or exercise therapist your insurer has a contract with. If not, only part of the cost may be reimbursed. This also applies if your doctor refers you to a specialised physiotherapist.

The basic package is the same for everyone who lives or works in the Netherlands, but each insurer decides who provides the care and where. Zorginstituut Nederland advises always checking your policy conditions, and asking your insurer exactly what you will be reimbursed.

7. Other payers: municipality, school and Wlz

Sometimes physiotherapy is paid another way, according to Zorginstituut Nederland:

• Municipality: may pay (part of) the costs if you receive a Wmo provision and need training or guidance to use it, or if you join an exercise programme organised by the municipality. Ask beforehand.
• Schools: may pay for exercise lessons without a medical purpose.
• Wlz: if physiotherapy is part of treatment under the Wet langdurige zorg (long-term care act), it is paid from the Wlz.

If a long-term condition keeps you from working, see our guide to sick leave in the Netherlands.

8. FAQ

Is physiotherapy covered by basic insurance in the Netherlands?

Only for certain conditions. Children are covered for more. Adults are covered from the first treatment for a few conditions (such as hip or knee osteoarthritis) and from the 21st treatment for conditions on the chronic list.

Do I need a referral for physiotherapy?

Sometimes. Zorginstituut Nederland says your insurer may require a referral from your GP or specialist; check your policy.

How many physiotherapy sessions does a child get?

For conditions not on the chronic list, 9 treatments a year, plus up to 9 more if needed. For listed chronic conditions, all needed treatments.

Why do I have to pay the first 20 treatments?

For adults with a condition on the chronic list, the rule is that basic insurance pays from the 21st treatment. The first 20 are paid yourself, or possibly by supplementary insurance.

Does physiotherapy count towards the eigen risico?

Yes, covered physiotherapy for adults falls under the compulsory eigen risico, which is €385 in 2026.

Is physiotherapy for a complaint that is not on the list covered?

Not by basic insurance for adults. Only the conditions in section 3 and the chronic conditions list qualify. Supplementary insurance may cover other treatments.

🇳🇱 Dutch Corner

Sources

• Zorginstituut Nederland: Fysiotherapie en oefentherapie (Zvw) (checked 28 October 2026)
• Rijksoverheid: Wanneer betaal ik een eigen risico? (€385 in 2026; checked 28 October 2026)