In France, every liberal health professional who wishes to bill for services to the Health Insurance must have an AM number. This number, distinct from the RPPS and FINESS, directly conditions the ability to electronically transmit invoices and receive reimbursements. Without it, liberal activity is administratively paralyzed, even if the practitioner has all other regulatory identifiers.
AM Number and Electronic Transmission: The Key to Liberal Billing
The AM number is not just another administrative code. It specifically identifies the liberal activity of a health professional with the Health Insurance funds. While the RPPS follows the practitioner throughout their career regardless of their mode of practice, the AM number is linked to the location and legal status of the activity.
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The same professional can hold multiple AM numbers if they practice in several offices or under different legal structures. This feature radically distinguishes it from the RPPS, which is a unique identifier assigned for life.
In practice, it is the AM number that enables billing. Without it, the electronic transmission of invoices is blocked. Pharmacies cannot process prescriptions, services are not settled, and the practitioner receives no reimbursements from the funds. An article detailing the importance of the AM number for practitioners discusses the concrete consequences of this administrative dependency.
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Billing Rejections Related to the AM Number: What Blocks in Practice
Field reports show that using an old AM number causes billing rejections and blocks electronic transmission in pharmacies. The most common case involves doctors who change their place of practice without updating their identifier with the CPAM. Prescriptions issued with an expired AM number are rejected by the system, leading to reimbursement delays for patients and unpaid bills for the practitioner.
The problem also affects retired doctors who maintain occasional activity. The residual use of an AM number associated with an old structure on the prescriptions of a retired prescriber blocks the billing chain. Switching to exclusive use of the RPPS as a personal identifier does not solve the problem, as the RPPS alone does not allow billing for liberal acts.
For substitutes, the situation is different but equally restrictive. A substitute doctor who does not yet have a definitive identifier can temporarily use a provisional AM number. Available data does not allow for a conclusion on the average duration of this transitional phase, but the practitioners concerned regularly report difficulties in obtaining this number in a timeframe compatible with the start of their activity.
AM Number Assignment: Concrete Steps for Health Professionals
The AM number is issued upon registration with the Health Insurance. This process occurs after obtaining the RPPS number (via registration with the relevant professional order or with the ARS for non-ordinal professions). The two identifiers respond to different logics and are managed by distinct organizations.
Here are the necessary elements to obtain an AM number:
- A valid RPPS number, certifying the right to practice the relevant health profession
- The choice of a specific place of practice, as the AM number depends on the geographical location of the office
- Registration with the CPAM of the installation department, providing identity and diploma proofs
- Possible signing of a convention with the Health Insurance, which conditions the applicable tariff sector
The procedure seems linear on paper. However, processing times vary according to the CPAM. Some practitioners report weeks of waiting before they can electronically transmit their first invoice, which delays the effective start of their liberal activity.
AM Number, RPPS, and FINESS: Understanding the Relationship Between Health Identifiers
Confusion between these three identifiers remains common, even among health professionals themselves. Each identifier serves a specific function in the health system, and none can substitute for another.
The RPPS is an 11-digit national identifier, unique and assigned for life. It identifies the individual, regardless of their mode or place of practice. It has definitively replaced the ADELI directory, which closed in October 2024.
The FINESS number identifies establishments and structures (group practices, health houses, clinics). It consists of 9 characters, the first two indicating the department. A liberal practitioner working alone does not always have their own FINESS number, while they must have an RPPS and an AM number to bill.
The AM number, finally, links the practitioner to the reimbursement system. It depends on the place of practice and the legal status of the activity. A professional moving from salaried employment to liberal practice, or opening a second office, will need to obtain a new AM number, while their RPPS remains unchanged.
Closure of ADELI and Migration to RPPS: Effects on the AM Number
Since the definitive closure of the ADELI directory in October 2024, all health professionals are now identified by an RPPS number. The old ADELI numbers have been automatically converted. This migration, led by the Agency for Digital Health (ANS), clarifies the landscape of identifiers but does not eliminate the AM number.
The AM number retains its own role in the billing chain. Practitioners who worked under an old ADELI number, sometimes confused with their AM number, must ensure that their billing software and medical stamps are up to date. Field reports vary on this point: some software publishers have automated the transition, while others require manual intervention from the practitioner.
For paramedical professions recently integrated into the RPPS (such as orthotists-orthesis or podiatrists since 2024), obtaining the AM number remains a distinct process to be carried out with the CPAM after registration in the national directory.
The AM number remains the identifier without which no liberal billing is completed. Regardless of the evolution of national directories, this direct link between the practitioner and the reimbursement system does not disappear. Professionals who set up or change structures should verify the validity of their AM number even before receiving their first patient.