BelRAI explained: the Screener, Home Care and the shift from Katz

BelRAI is the Belgian implementation of the interRAI assessment instruments — an internationally validated family of tools for measuring how care-dependent a person is and how they function day to day. It runs as a federal eHealth service, so an assessment made by one care team can be shared, with consent, across the organisations around a patient. For home-care organisations it matters because BelRAI is gradually becoming the shared language for care needs. In some places it already replaces older scales.

This guide explains what BelRAI is, how the Screener differs from the full Home Care assessment, and where the shift away from the Katz scale actually stands. That last part is still moving, so read the dates as “true when checked”, not “settled”.

What BelRAI is

BelRAI is the Belgian version of interRAI. interRAI is an international research network that builds standardized assessment instruments; BelRAI adapts them for Belgium and hosts them centrally on the federal eHealth platform. The point of a standardized instrument is simple: different professionals, such as a home nurse, a family-care service and a hospital, describe the same patient in the same structured way. The assessment can then travel with the person instead of being redone from scratch at every hand-off.

Practically, BelRAI is both a method (the instruments and how you score them) and a system (the central web application and the web services that let care software read and write assessments). An organization can work directly in the BelRAI web application, or integrate BelRAI into its own care software through the eHealth web services.

The BelRAI Screener vs the full BelRAI Home Care assessment

The two instruments home-care teams meet most often are the Screener and BelRAI Home Care.

The BelRAI Screener is the short one. It pulls together a compact set of interRAI items on physical and psychological functioning and on activities of daily living, and produces a score, on a 0 to 30 scale in the Flemish elderly-care-budget context. Its job is to give a fast, standardized first read of someone’s situation: enough to gauge care needs and to flag whether a fuller assessment is needed. In Flanders the Screener has been the mandatory instrument in family care (gezinszorg) since 2021.

The full BelRAI Home Care (HC) assessment is the comprehensive one, meant for people living at home with complex, longer-term needs. It maps physical, cognitive, psychological and social functioning in much more detail and generates care-planning outputs (care scales and “CAP” problem domains) that a Screener does not. It takes longer and is done by trained assessors.

The simplest distinction: the Screener tells you roughly where someone stands and whether to look closer. The full Home Care assessment is the close look that feeds an actual care plan.

A worked example

Take a family-care service in Flanders visiting an older client for the first time. Because the Screener is the mandatory instrument in family care (gezinszorg), the assessor works through its compact set of interRAI items on physical and psychological functioning and on activities of daily living, and lands on a score on the 0 to 30 scale used in the Flemish elderly-care-budget context. If the picture is light — the person is largely self-reliant with limited needs — the standardized first read is enough, and no fuller assessment is triggered. If instead the Screener surfaces complex, longer-term needs, that is the signal to look closer: the client is a candidate for a full BelRAI Home Care assessment, done by a trained assessor, which maps functioning in detail and produces the care-planning outputs (care scales and CAP problem domains) the Screener does not. Same person, two instruments, each doing the job the other cannot.

The shift away from Katz, and the timeline

This is the part to handle carefully, because it is genuinely in motion and it differs by region and by sector.

For home nursing financed through RIZIV/INAMI, the Katz scale of article 8 of the nomenclature is still the determining instrument for the A/B/C forfaits today. If you bill home-nursing care, Katz has not gone away.

At the same time, a federal pilot project on new home-nursing financing has launched, with BelRAI as the central instrument for mapping care needs. In that pilot, financing is no longer tied directly to the Katz scale, but the Katz scale is still recorded (for administrative and patient-rights reasons). The pilot is voluntary, runs for about two years, and is being evaluated scientifically before any general rollout. In other words: BelRAI is being tested as the future basis for home-nursing financing, but as of this writing it has not replaced Katz across the board, and whether or when it will is not yet settled.

Separately, in Flanders’ elderly care budget (zorgbudget voor ouderen met een zorgnood), the BelRAI Screener is set to become the official measuring instrument in place of the older medical-social scale for new applications from 1 March 2026. That is a regional social-protection change, not the same thing as the federal home-nursing financing pilot; the two are easy to conflate. How the federal RIZIV forfaits and these regional budgets sit side by side is set out in the overview of how Belgium assesses and finances home nursing.

The plain summary: BelRAI is gaining ground, and in several Flemish contexts it is already the rule. For RIZIV home-nursing financing, though, the Katz scale still governs today. The replacement timeline is a mix of confirmed regional steps and a federal pilot whose outcome is not yet law. Confirm the current state for your own sector and region before acting on it.

The regional picture

Care assessment in Belgium is split across the federal level and the regions, and BelRAI adoption reflects that split.

At the federal level, BelRAI is the shared eHealth service and the instruments themselves; the RIZIV/INAMI home-nursing rules (Katz, and the financing pilot) sit here.

In Flanders, BelRAI is furthest along: the Screener is mandatory in family care, BelRAI LTCF is the mandatory care-planning instrument in nursing homes (phased in over 2023 to 2025), and the Screener is moving into the elderly care budget in 2026.

For Wallonia and Brussels, the publicly available picture is less uniform and less documented than the Flemish one, with regional bodies (AViQ in Wallonia, Iriscare in Brussels) organizing home care under their own frameworks. If you operate there, treat the Flemish timeline as Flemish, not Belgian, and verify locally.

What it means for your software and how to prepare

Whichever instrument applies to you, the tooling consequence is the same: assessment stops being a private form inside one program. It becomes structured data that has to move.

BelRAI lives on the federal eHealth platform and exchanges assessments through web services. Software built only around the Katz scale, a local form that produces an A/B/C forfait, does not speak BelRAI. To keep up, care software needs to hold BelRAI data (Screener and, where relevant, full Home Care items and their outputs), connect to the eHealth BelRAI services or the central application, and fit the assessment into real workflows: who assesses, when a Screener triggers a full assessment, how results feed the care plan, and how Katz and BelRAI coexist during the transition.

For an organisation the practical preparation is plain but concrete: know which instrument your sector and region require and by when; make sure whoever assesses is trained on the instrument, not just the software; and check with your software supplier whether they support BelRAI through eHealth today, on what timeline, and what it costs. Off-the-shelf packages move at their own pace, which is often where the mismatch with your workflow appears.

Frequently asked questions

What is the difference between the BelRAI Screener and the full BelRAI Home Care assessment?

The Screener is a short first assessment that gives a quick, standardized picture of someone’s care needs and helps decide whether a fuller evaluation is warranted. The full BelRAI Home Care assessment is the comprehensive instrument for people at home with complex, long-term needs: it maps physical, cognitive, psychological and social functioning in detail.

Is BelRAI replacing the Katz scale for home nursing?

Not yet, and not everywhere. For the RIZIV/INAMI home-nursing forfaits, the Katz scale of article 8 is still the rule today. A federal pilot on new home-nursing financing puts BelRAI at the centre of care planning, but even there the Katz scale is still recorded. This area is moving; check the current state before you rely on it.

Who has to use BelRAI, and where?

It depends on region and sector. In Flanders the BelRAI Screener is mandatory in family care and is being introduced for the elderly care budget, and BelRAI LTCF is mandatory in nursing homes. The picture in Wallonia and Brussels differs and is less uniform.

Does our software need to change for BelRAI?

Usually yes. BelRAI runs on the federal eHealth platform and exchanges assessment data through web services. Software that only knows Katz has to add BelRAI data, the eHealth integration, and the workflows around it, or connect to the central BelRAI application.

When the assessment changes, your software has to keep up

BelRAI turns care-needs assessment into shared, structured data that has to move between systems while instruments and rules keep shifting. Off-the-shelf software can lag behind that kind of workflow change. AppSky builds software for home-nursing and home-care teams, where assessment, care planning and billing sit in one flow and can follow the rules as they change. When we wire assessment into the eHealth services for these teams, the hard part is rarely the score itself — it is fitting the Screener-to-full-assessment handoff, and the Katz-and-BelRAI overlap, into the way a team already works. See what we did for Domihome, or book an intro call.

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This guide is informational and not billing, legal or medical advice. BelRAI and its rollout are evolving and differ by region and sector: confirm current rules with the official sources, including the federal eHealth BelRAI page, RIZIV/INAMI, and, in Flanders, Departement Zorg. Last verified 12 July 2026.