Referral procedure for proton therapy

Information for referring physicians about which patients qualify for proton therapy, how the application needs to be submitted and information on follow-up during and after treatment.

For international patients

The referral procedure below applies to Belgian patients. There is a separate procedure for international patients.

Who can refer?

Patients that meet certain conditions can qualify for the reimbursment of a treatment with proton therapy via a specific procedure as described on the website of NIHDI.

The Scientific Committee and the Agreement Council for proton therapy drew up a list of indications and additional inclusion criteria. The Health Insurance Committee approved these.

Within the context of the compulsory health care insurance (insurance for medical care), only certified radiotherapy centres that have an agreement with NIHDI can refer patients to a specialised proton therapy centre, including the proton therapy centre PARTICLE.

It is therefore not possible for patients to apply directly for a proton therapy treatment. If you have questions about whether proton therapy would be an option for you, it's best to discuss this first with your attending radiation-oncologist.


  1. If proton therapy is the only therapy or the most appropriate one for the patient according to the report of a multidisciplinary oncology consultation (MOC), the attending physician can contact one of the radiotherapy centres in Belgium that can refer the patient to a specialised hadron therapy centre, including PARTICLE.
    A multidisciplinary report is also required in case of benign disorders that can be considered.
  2. Before sending an application for proton therapy to PARTICLE, the referral centre will first send an application to NIHDI, Department for Medical Care (DGV) to open a record ( DGV will issue a record number in anticipation of the complete application file.
  3. Subsequently, the radiation-oncologist of the referral centre will send an application for proton therapy to PARTICLE. This can be done via the online registration form which is available in different languages. In case there are problems with the registration form, it is also possible to send a mail to with the file number as issued by DGV in the subject line and the question to register a patient without already including any confidential information in the mail. PARTICLE will then send you a secure link to provide this information. Exchanging medical information between care provider is in principle possible via eHealth is the patient has given permission. As this will simplify the administrative process significantly, it is strongly recommended to discuss this with patient.
  4. All applications for proton therapy are subsequently discussed at the so-called proton round. This multidisciplinary consultation takes place every Monday afternoon (except on public holidays). Only when the registration form is completed fully and all necessary information is available, at the latest by Friday, 12 o'clock noon, the patient will be discussed at the next proton round. Ideally the referring radiation-oncologist will present the case. If necessary the GP can also participate online when his/her patient is being discussed. Please mail to to ask to participate to the proton round. Put the record number in the mail's subject line. In some cases it is possible that PARTICLE will ask for additional information before reaching a decision.
  5. After the proton round the referring centre will be informed about the decision to a proton therapy treatment in PARTICLE.
    • In case of a positive decision, the referring centre will send a full application file, including the positive recommendation to treat by PARTICLE, to DGV (
    • In case of a negative decision, PARTICLE will provide the referring centre with a statement. The referring centre informs DGV of the decision.
  6. Within 5 working days after receipt, DGV will pass on the complete application file to the members of the Agreement Council who will decide on the reimbursment of the treatment and any travel and accommodation costs.


  1. After a positive decision of the Agreement Council, the patient can be treated with proton therapy. The referring centre will coordinate the referral to PARTICLE.
  2. If additional treatment is required (e.g. concomitant chemotherapy), the referring centre and PARTICLE will consult. These additional treatments are performed in the referring centre as much as possible. For questions, you can always contact PARTICLE (e-mail:, mention the record number in the mail's subject line).

After the treatment

  1. After the treatment, PARTICLE will directly send the invoice for the proton therapy treatment to DGV. DGV will then directly pay PARTICLE for the costs of the proton therapy treatment.
  2. The referring radiotherapy centre receives a recompensation for the coordination from DGV, after having issued the required invoce.
  3. After the treatment is complete, all medical reports about the proton treatment are sent to the referring centre/attending physician.
  4. The referring centre is responsible for the mandatory annual registration of the follow-up data with the Stichting Kankerregister.

Schematic overview

Want to know more?

For more information about the procedure you can check the NIHDI website.

Last edit: 23 April 2021