The fee for a consultation with an on-call doctor is not limited to the price displayed in the daytime office. Several surcharges apply depending on the time, day, and location of the consultation. Understanding these mechanisms before going allows one to anticipate the actual out-of-pocket expenses, especially when lacking suitable supplementary health insurance.
On-call surcharges: the pricing mechanism that the patient discovers on their bill
Outside of the standard office hours, an on-call doctor applies a surcharge to the basic conventional rate. This additional charge is not left to the discretion of the practitioner: it follows a scale set by the Health Insurance.
Three variables determine the final amount. The time slot first: an evening consultation (before midnight) costs less than a deep night consultation (between midnight and 6 a.m.). The day next: Sundays and public holidays incur a specific surcharge. The location finally: a home visit is more expensive than a consultation in the office or in an on-call medical center.
To better visualize these differences, find the rates applied on Santéducation, which details the amounts by time slot and type of consultation.
The patient therefore pays a base fee (the consultation with the contracted general practitioner) to which the corresponding surcharge is added. All of this is detailed on the care sheet or the statement provided by the doctor.
Comparative table of surcharges by time slot and location
The surcharge amounts vary significantly from one time slot to another. Here is a summary of the differences for a doctor registered on the on-call list in metropolitan France.
| Time Slot | Surcharge in office or fixed point | Surcharge for home visit |
|---|---|---|
| Evening (8 p.m. – midnight) and morning (6 a.m. – 8 a.m.) | €35 | €42.50 |
| Deep night (midnight – 6 a.m.) | €40 | Amount higher than the evening |
| Sunday and public holiday | Specific surcharge applied | Cumulative surcharge (day + home) |
The deep night and home visits accumulate the highest surcharges. A patient who calls an on-call doctor to their home at 3 a.m. pays the base consultation fee, the deep night surcharge, and the additional fee related to the home visit.
In contrast, going to an on-call medical center (fixed point) in the evening limits the bill to the base rate plus the lowest surcharge on the scale.
Order of August 5, 2026: what changes in the remuneration of on-call services
An order published on August 5, 2026, modified the 2011 text governing the flat-rate remuneration of doctors participating in the continuous care system (PDSA). Two changes deserve the attention of patients, even if they primarily concern practitioners.
- The minimum flat rate of €180 for 12 hours of on-call duty is maintained, but the text now clearly distinguishes between fixed point on-call duty and home visits. This separation formalizes what the surcharge scale already implied for the patient: the consultation location conditions the cost.
- Telephone medical regulation (the doctor who directs calls before any consultation) is no longer within the scope of this order. Its remuneration now falls under the medical convention, following a decree of July 7, 2026.
- Some ARS have initiated increases in the liberal regulation flat rate. In New Aquitaine, this flat rate increases from €100 to €115 per hour in the evening and from €115 to €130 per hour in deep night. These amounts do not directly change the fee paid by the patient but influence the availability of on-call doctors in the area.
This last point is rarely highlighted. The remuneration of the doctor conditions the available on-call service in a given geographical area. A flat rate deemed insufficient by practitioners reduces the number of volunteers, which lengthens waiting times or redirects the patient to hospital emergencies, with a much higher collective cost.
Sector 1, sector 2, and non-contracted doctor: the gap in out-of-pocket expenses
The contractual status of the on-call doctor significantly modifies the reimbursement. A sector 1 general practitioner applies the base rate without exceeding fees. The Health Insurance reimburses on this basis, and the supplementary health insurance covers the rest according to the subscribed contract.
A sector 2 doctor, on the other hand, can charge exceeding fees in addition to the on-call surcharges. The reimbursement from Social Security remains calculated on the conventional rate: the excess is entirely the patient’s responsibility if their mutual insurance does not provide for specific coverage (OPTAM option or excess fee flat rate).
Non-contracted doctors (sector 3) practice free fees. The reimbursement from the Health Insurance is then minimal. Starting January 1, 2027, prescriptions from sector 3 doctors will no longer be reimbursed, further reducing the interest in consulting a non-contracted practitioner on call.
Fixed point or home visit: the choice that weighs most on the bill
Between a consultation in an on-call medical center and a home visit during deep night, the price difference can represent several tens of euros. Moving to a fixed point, when health conditions allow, remains the most direct lever to limit costs.
On-call medical centers have developed in many urban areas. They gather on-call doctors in a single location, often situated near a hospital or care center. The patient benefits from the lowest increased consultation rate on the scale, without additional travel fees.
The bill from an on-call doctor therefore depends less on the practitioner themselves than on three combined parameters: the time slot, the consultation location, and the contractual sector. Checking these three elements before calling helps avoid unexpected out-of-pocket expenses.