SACYL updates the maximum contracted rates for rehabilitation and speech therapy

The Regional Health Management of Castilla y León (SACYL) has set the new maximum rates for contracted healthcare for special rehabilitation and speech therapy treatment services. This is done through the Resolution of October 13, 2026, from the Presidency of the Regional Health Management, published in the Official Gazette of Castilla y León no. 202, of October 19, 2026, in section I.D (Other provisions), with reference BOCYL-D-19102026-202-34. The regulation takes effect on the day of its publication.

The resolution is based on article 31.2 f) of Law 8/2010, of August 30, on the Organization of the Health System of Castilla y León, which grants the president of the Regional Health Management the competence to approve, modify, and review the rates for the contracting of services, following notification to the Castilian and Leonese Health Council in accordance with Decree 20/2013, of June 13. The text also invokes article 90 of Law 14/1986, General Health Law, regarding contracts with external means, and article 64 of Law 8/2010, which subjects the relationship with private initiatives to the principles of publicity, transparency, objectivity, efficiency, and good administration.

Until now, the rates from the Resolution of November 21, 2011 (Annex IV, “Special treatment services”) were applicable, supplemented by two resolutions of May 28, 2014 —pelvic floor dysfunction rehabilitation and rehabilitation of primary or secondary language development disorders due to hearing loss— and by the Resolution of February 11, 2016, which introduced the per-session rate for incomplete treatments.

A revision motivated by the evolution of costs

The regional Executive justifies the update based on the increasing cost of materials, personnel, and the renewal of therapeutic devices and equipment, so that the provision is carried out “with quality standards.” The stated objective is to adapt the remuneration framework to real costs and the evolution of healthcare needs, guaranteeing the sustainability of the system and “sufficient competition in public procurement procedures.”

The resolution also introduces a design change: instead of a single rate per process, a graduation is established according to the degree of complexity —simple or complex— in order to adapt the treatment to the circumstances of each patient according to clinical practice guidelines. Additionally, home rehabilitation is updated due to the cost incurred by the travel of healthcare professionals to the home.

Two zones and six blocks in the annex

The annex of the resolution is structured into six sections:

• Outpatient rehabilitation.
• Home rehabilitation.
• Outpatient speech therapy.
• Home speech therapy.
• Zoning of home care.
• Billing procedure for treatments.

Home care is divided into two isochronous zones, calculated by the road travel time from the patient’s home to the reference point established in the tender (the contracting management, the hospital, or the specialty center of the lot):

• Zone 1: up to 30 minutes of travel.
• Zone 2: more than 30 minutes.

Main amounts

Among the approved maximum rates, the following stand out for outpatient rehabilitation:

• Stroke with hemiplegia and language and/or speech impairment: €729.64 for simple grade and €1,431.44 for complex.
• Traumatic brain injuries with language and/or speech impairment: €855.85 and €1,352.68.
• Pelvic floor dysfunction: €260.30 and €405.19.
• Ischemic heart disease with low cardiovascular risk: €236.41; medium risk: €262.08.

In outpatient speech therapy, amounts range from €111.59 for simple grade voice disorders to €1,433.99 for cochlear implants in pre-verbal patients in the postoperative phase; adult dysphagia reaches €1,065.11 for complex grade. In home speech therapy, aphasia and/or apraxia is priced at €414.86 (zone 1, simple) and up to €1,976.83 (zone 2, complex).

Billing by process and limited scope

Billing is carried out by complete processes, with two exceptions: when more than 50% of the planned sessions have been executed, the entity may bill 50% of the price as a down payment; and treatments finished without being completed may be billed per session, applying the proportion between sessions performed and total sessions of the treatment.

The resolution nullifies sections 5 to 13 of Annex IV of the Resolution of November 21, 2011 regarding these services, as well as the two resolutions of May 28, 2014, and the Resolution of February 11, 2016. However, the new rates will not be applicable to agreements and contracts in force at the time of publication nor to those in the bidding phase. The Economic, Budgetary and Financial Director is authorized to adopt development measures, and the contracting of different services will require a prior report from the General Directorate of Healthcare Assistance. The text is signed in Valladolid, on October 13, 2026, by the president of the Regional Health Management, Alejandro Vázquez Ramos.

The impact is twofold: it establishes the payment floor for clinics and private centers that contract these therapies with the public system and, by increasing the amounts for the most complex processes and home care, it aims to sustain the supply of contracted rehabilitation and speech therapy places upon which thousands of patients in Castilla y León depend.

Source: Official Gazette of Castilla y León, no. 202, October 19, 2026, section I.D (Other provisions), pp. 232-292 (official reference: BOCYL-D-19102026-202-34).