CPAM-approved taxi: how to get approved for seated patient transport

To become a CPAM-approved taxi, you must hold a valid parking authorisation (ADS), operate the vehicle, then sign the departmental standard convention with the local health insurance fund (CPAM), under article L322-5 of the social security code. This approval lets you bill the Assurance maladie for medically prescribed seated patient transport, with third-party payment.

Seated patient transport prescribed by a doctor can be covered by the Assurance maladie. But a taxi cannot bill these trips to the CPAM by default: it must first be approved (conventionné).

In practice, approval is the signature of a standard convention, specific to each department, between the taxi operator and the CPAM. This convention sets the framework for coverage: applicable tariffs, agreed discount, billing and third-party payment rules. The legal basis is article L322-5 of the social security code.

Without this convention, a taxi remains a standard taxi: it can carry patients, but the customer pays the full fare and may seek reimbursement themselves. With the convention, the taxi becomes part of seated medical transport and gains access to a recurring patient base.

Two basic conditions frame access to approval:

• holding a valid parking authorisation (ADS), the title that allows operating as a taxi;
• actually operating the vehicle attached to that ADS;
• filing a request with the departmental CPAM and signing the standard convention offered.

In taxi start-up or business-takeover files, it is often the sequencing of these steps that creates friction: the ADS is obtained or transferred under local rules, and the approval request comes afterwards. It is wise to plan the timeline, because approval is not automatic.

An often underestimated point: approval is subject to a quota. Each department sets a maximum number of approved taxis, a form of local numerus clausus. When that quota is reached, your request may be placed on a waiting list.

This is strategic information before any installation project geared towards medical transport. If you buy an ADS counting on seated transport revenue, first check whether approval is available in the target department. An equipped vehicle and a valid ADS do not guarantee immediate access to the convention.

By signing the convention, you accept two major counterparts.

First, approved trips follow a tariff framework defined by the convention, distinct from your usual pricing freedom on standard trips.

Second, in exchange for third-party payment and access to this patient base, you grant a discount on the applicable prefectural tariff. The rate of this discount is negotiated in the convention and varies by department. In other words, an approved trip is billed at a level lower than an equivalent standard trip. That is the entry price for a regular, addressed flow of business.

The approved taxi applies third-party payment: the patient does not pay the share covered by the Assurance maladie. You bill that mandatory share directly to the CPAM, usually by electronic transmission, with the supporting documents sent (a scanning system such as SCOR).

The effect on cash flow is concrete: you complete the trip, but collection of the CPAM share happens with a delay. This share must be tracked as a receivable, just like a customer invoice awaiting payment. The higher the share of your turnover coming from approved trips, the more this delay weighs on your working capital requirement.

Passenger transport, including seated patient transport by taxi, falls under the reduced VAT rate of 10 % (article 279 of the general tax code). This rate applies whether the trip is standard or approved.

On the steering side, approval transforms the business model. You gain a recurring, identified flow, but you bear a payment delay and a tariff discount. Profitability therefore no longer reads trip by trip: it is steered on three levers, the volume of activity, the CPAM collection time, and the mix between approved and standard trips.

• Check that your ADS is valid and that you operate the attached vehicle.
• Confirm approval availability in the department (quota).
• File the request with the CPAM and read the standard convention carefully.
• Measure the effect of the discount on your effective fare per trip.
• Set up tracking of CPAM receivables and collection time.
• Separate approved takings and standard trips in your bookkeeping.
• Anticipate the impact of the payment delay on your cash flow.

An operator who shifts a large share of activity towards approved trips often sees turnover stabilise, but cash flow tighten in the first months: trips are completed, the CPAM payment arrives later. The sound management reflex is then to provision this receivable, track the actual settlement time, and balance the activity mix so as not to depend solely on the approved flow.

Approval is a solid growth lever, provided it is built into rigorous steering. If you structure or take over a taxi business geared towards medical transport, our firm supports you on takings tracking, cash-flow steering and sector-specific taxation: see our dedicated page on the accountant for taxis.

This article provides general information. A decision specific to your situation requires reviewing your file, your department and the rules in force.