Seven Areas of Tests the SNS Buys From Private Labs Still Carry 2014 Prices, With No Rule to Update Them, Says a Study Paid For by the Providers
A study for the private providers' federation finds the SNS has no method for updating the prices it pays contracted labs and clinics for about one billion euros a year of tests. Seven areas have had no change since 2014. For patients, these tests carry no user charge.
The Serviço Nacional de Saúde (SNS, the National Health Service) has no regular mechanism for updating the prices it pays private laboratories and clinics to carry out tests and scans on its behalf, and in seven areas those prices have not changed since 2014. That is the conclusion of a study presented in Lisbon on Tuesday, Lusa reported, in a story carried by Notícias ao Minuto.
The study was commissioned by the Federação Nacional de Prestadores de Cuidados de Saúde (FNS, the National Federation of Healthcare Providers), which represents the private providers concerned, and written by Ricardo Gonçalves and Mariana Cunha of the Centro de Estudos de Gestão e Economia Aplicada (CEGEA, the Centre for Management and Applied Economics Studies) at Católica Porto Business School. It has not been published online, so the figures below are as Lusa reported them.
What the study found
According to FNS data cited by Lusa, the contracted private sector carried out more than 145 million tests and procedures for the SNS in 2025, up 55.8 percent on the 93.4 million of 2015. Public spending on that work came to about one billion euros in 2025.
The authors say the root problem is that there is no method for calculating the price table at all. Changes have been "typically one-off and reactive rather than periodic" (translated by us), made in response to budget pressure or public complaints from providers. Between 2014 and 2026, 88.2 percent of nuclear medicine procedures and 74.9 percent of radiology procedures had their prices revised, but only 9.9 percent of clinical analyses did. Physical medicine and rehabilitation, ear, nose and throat, pulmonology, immunoallergology, urology, neurophysiology and electroencephalography saw no changes at all.
The study also notes that prices are the same across the whole country, which it says can leave areas with higher costs or scattered demand short of providers. It proposes an update formula that could vary prices by region. FNS president Eduardo Moniz called for "a clear, objective and periodic regulatory model" (translated by us) set by the public authorities.
What the official record shows
The price lists are published by the Administração Central do Sistema de Saúde (ACSS, the Central Administration of the Health System) on its contracted sector page, where the archive of tables runs back to April 2014. Under Decreto-Lei n.º 139/2013 (Decree-Law 139/2013), the maximum prices are those in the SNS price table, and the health minister may set lower ones by order.
The latest revision shows the pattern the study describes. An ACSS circular of 28 April 2026 explains that orders in February and April 2026 updated prices for 26 clinical analyses, made an "almost complete" revision of the radiology table, and added two new tests: faecal calprotectin, a marker for inflammatory bowel disease, at 36.50 euros, and digital breast tomosynthesis (3D mammography) at 60 euros.
What this means for patients
Contracted providers are where many SNS patients go for blood tests, X-rays and scans prescribed by their family doctor. ACSS says one aim of the system is to guarantee patients' free choice of provider. Since June 2022, under Decreto-Lei n.º 37/2022, SNS user charges apply only in hospital emergency departments, so a test done at a contracted lab on an SNS prescription carries no user charge.
The providers' argument is that a single national price that does not track costs can leave some regions short of contracted labs. The study was paid for by the providers whose fees it examines; the Lusa report we read carried no response from the Ministry of Health or ACSS.
