Referral ticket · health-insurance rules
Is my referral ticket still valid?
Two tickets issued on the same day can run for 30, 60 or 90 days, depending on what the doctor sent you for. Pick the kind, enter the issue date and your appointment date, and see where you land.
Result
Example with fixed dates: ticket issued on 1 October 2026, appointment on 15 November 2026 (45 days). Enter your own dates to replace it.
| Category | Period | With your appointment |
|---|---|---|
| Specialist · acute or subacute | at most 30 days | past it |
| Specialist · chronic | up to 90 days | inside |
| Specialist · palliative care | up to 90 days | inside |
| Specialist · case management | 90 days | inside |
| Ordinary tests | at most 30 days | past it |
| Tests from a preventive visit | up to 60 days | inside |
| Tests for a chronic illness | up to 90 days | inside |
| Histopathology, cytology, immunohistochemistry | 90 days | inside |
| Tests · case management | 90 days | inside |
| MRI, CT, scintigraphy, angiography | 90 days | inside |
The same dates, category by category#
The ticket on a timeline
| Category | Period | Last safe day | With your appointment |
|---|
Which term your ticket has#
There is no single term. The rules of CNAS (the National Health Insurance House) tie the term to the kind of ticket. The table below holds the categories in the rules, with the place of each.
| Kind of ticket | Period | In the rules |
|---|---|---|
| Specialist | ||
| Acute or subacute condition | at most 30 days | Order MS/CNAS 1,857/441/2023, annex 8, art. 11(2) |
| Chronic condition | up to 90 days | Order MS/CNAS 1,857/441/2023, annex 8, art. 11(2) |
| Palliative care as an outpatient | up to 90 days | Order MS/CNAS 1,857/441/2023, annex 8, art. 11(2) |
| Marked “management de caz” (case management) | 90 days | Order MS/CNAS 1,857/441/2023, annex 8, art. 11(2) |
| Tests and investigations | ||
| Ordinary tests and investigations | at most 30 days | Order MS/CNAS 1,857/441/2023, annex 18, art. 4(1) |
| Recommended at a preventive visit with the family doctor | up to 60 days | Order MS/CNAS 1,857/441/2023, annex 18, art. 5 |
| For a chronic illness | up to 90 days | Order MS/CNAS 1,857/441/2023, annex 18, art. 4(1) |
| Histopathology, cytology, immunohistochemistry | 90 days | Order MS/CNAS 1,857/441/2023, annex 18, art. 4(1) |
| Marked “management de caz” (case management) | 90 days | Order MS/CNAS 1,857/441/2023, annex 18, art. 4(1) |
| High performance | ||
| High-performance investigation ticket | 90 days | Order MS/CNAS 1,857/441/2023, annex 18, art. 5 |
Where the rule says “up to”, it gives a ceiling, and the calculator uses it. If the ticket states a shorter term, confirm it with the provider. Terms are counted in calendar days, not working days, so Saturdays and Sundays count.
Two 60-day rules, two different things#
The first is the ticket’s term for investigations recommended at a preventive visit with the family doctor: up to 60 days from issue.
The second concerns specialist consultations. For the same episode of acute or subacute illness, or a flare-up of a chronic one, one ticket covers up to three consultations within at most 60 days of the first. It does not extend the validity of the ticket for the first consultation: that keeps its own term: 30 days, or up to 90.
So the ticket is used first for the first consultation, within its own term. The 60 days for follow-ups in the same episode run from then.
The last day: is the issue day counted?#
The rule says “at most 30 calendar days from the issue date”. It does not say whether the issue day is day 1 or day 0.
A ticket issued on 1 March has its last safe day on 30 March (if 1 March is day 1) and its last possible day on 31 March (if 1 March is not counted). The calculator shows both dates. Up to the first, you are inside the term however it is counted. The second, 31 March, stays “at the limit”: the clinic or the insurance house says which reading applies.
The page never says “guaranteed valid”, not even in the middle of the period. The calculator compares dates. It cannot see how the clinic filled in the ticket or what the insurance house decides.
Hospital stays and booking: two rules for investigations#
Booking. If the investigations could not be done on the spot for objective reasons, the provider must book you within the ticket’s validity period. On the back it notes the date you came and the date booked. If you refuse the booking, the ticket is handed back and you can go to another provider.
Hospital stay. If you are admitted to hospital during the validity period without the recommended investigations having been done first, a ticket for paraclinical investigations loses its validity. High-performance investigations are an exception when they were not done during the stay, if you present the discharge note or medical letter showing this. The text exempts tickets for histopathology, cytology and immunohistochemistry from these provisions.
When you present the ticket, you declare on the back, on your own responsibility, whether you were admitted between issue and the investigations. For histopathology, cytology and immunohistochemistry the declaration is different: that you are not an inpatient or day patient at the moment the sample is taken. That is why the checkbox in the calculator never gives a green result: if you were admitted, ask for confirmation.
What the page does and does not do#
The page compares three dates with the terms in the rules. It asks for no personal ID number, name, diagnosis or photo of the ticket, and sends nothing anywhere: the dates stay on your device.
It cannot decide whether the ticket is filled in correctly, whether the service is reimbursed, or whether the rules changed after the text checked here. The result is indicative and does not replace confirmation from the clinic or the insurance house.
For physical medicine and rehabilitation, annex 8 speaks of a “referral ticket for the clinical specialty of physical medicine and rehabilitation”, and the text read gives no separate term. The procedures in a rehabilitation plan have their own rules, which the page does not check: confirm with the provider.
Frequently asked questions#
How long is a Romanian referral ticket valid?
It depends on the kind. For a specialist, an acute or subacute condition gets at most 30 calendar days from issue; a chronic one, up to 90. Ordinary tests and investigations get at most 30 days; those recommended at a preventive visit, up to 60; chronic-illness tests, up to 90. MRI, CT, scintigraphy and angiography get 90.
How long is a ticket for an MRI or CT valid?
A ticket for high-performance investigations (MRI, CT, scintigraphy, angiography) is valid for 90 days under annex 18, art. 5 of the CNAS rules.
How long is a ticket for lab tests valid?
For ordinary tests, at most 30 days. For those recommended at a preventive visit with the family doctor, up to 60. For chronic illnesses, up to 90. Histopathology, cytology and immunohistochemistry get 90 days, as do tickets marked “management de caz”.
What does “management de caz” (case management) mean on a ticket?
It is a mark on a ticket issued by the family doctor (for investigations, also by the outpatient specialist) for patients in the integrated management of some chronic illnesses: the rules name hypertension, dyslipidaemia, chronic kidney disease, type 2 diabetes, asthma and COPD. A ticket with this mark is valid for 90 days.
My ticket expires before my appointment. What do I do?
The texts read here contain no extension of a ticket after it expires. Ask the doctor for a new one before the appointment. If you came to the provider in time and the investigation could not be done on the spot, the provider must book you within the validity period.
Is the issue day counted?
The rule does not say. So the page shows two dates: the last safe day (issue is day 1) and the last possible day (issue is not counted). Between them you are at the limit and should confirm with the clinic.
Are the preventive 60 days the same as the 60 days after the first consultation?
No. The first is the ticket’s term for investigations recommended at a preventive visit. The second is the window in which up to three specialist consultations for the same episode can be done, counted from the first.
What happens if I am admitted to hospital before the appointment?
For paraclinical investigations, the ticket loses its validity if you were admitted before they were done. High-performance investigations have an exception: investigations not done during the stay, shown by the discharge note or medical letter. Histopathology, cytology and immunohistochemistry are exempted from these provisions.
Are the dates I enter saved?
No. The calculation runs on your device and the dates never leave the page. The page asks for no ID number, name or diagnosis.
Sources#
- CNAS: Order MS/CNAS no. 1,857/441/2023, methodological rules, version published in January 2026 (PDF, Romanian): annex 8 art. 11(2); annex 18 art. 4(1)-(2) and art. 5; annex 7 section B points 1.2.1 and 1.3.5
- Legislative Portal: Order 1,857/2023, consolidation history (Romanian)
- CentrulMedical.ro: how long a referral ticket is valid (editorial guide, updated 19 October 2026, Romanian)
- Prevencia: who issues a referral ticket and how long it is valid (updated 8 September 2026, Romanian)
- Veritate: tickets for tests are valid 30, 60 or 90 days (1 November 2026, Romanian)
The terms come from the text of the CNAS rules published in January 2026. The press articles and guides above explain the same rules and are not independent confirmations. On the Legislative Portal, the latest consolidation of the order shown on 6 November 2026 is that of 1 January 2026; the CNAS draft amendments of July 2026 are only drafts, with no act number. The result is indicative: the clinic and the insurance house give the confirmation.