Portugal – Complementary and Alternative Medicine

What types of complementary and alternative medicine are available in Portugal?

Portugal’s CAM sector is both well established and continuing to expand. Seven specific therapies have been given legal standing: acupuncture, homeopathy, osteopathy, naturopathy, phytotherapy, chiropractic, and Traditional Chinese Medicine. Under Portuguese law, these are formally described as terapêuticas não convencionais (non-conventional therapies, or NCT), and practitioners work within a clearly defined legal structure.

Among the seven regulated therapies, acupuncture and Traditional Chinese Medicine (TCM) tend to be the most readily accessible, especially in cities like Lisbon, Porto, and the Algarve region. Osteopathy has also gained a strong foothold, with a steadily growing number of clinics concentrated in urban centres. Phytotherapy — the medicinal use of plants — holds both a formally regulated professional dimension and a deep cultural significance in Portugal, where plant-based remedies have long featured in daily life.

Homeopathy is legally recognised and practised, though it is somewhat less prominent than in countries such as France or Germany, where it has historically occupied a more central place in public health culture. Chiropractic and naturopathy exist but remain less widespread, particularly beyond major cities. Modalities such as Ayurveda, reflexology, reiki, crystal healing, hypnotherapy, and various forms of bodywork are also available across Portugal, but none of these falls within the seven regulated NCTs, and no specific legal framework governs them. Expats considering these options should be aware that practitioners are not bound by the same licensing obligations as those offering regulated non-conventional therapies.

CAM establishments in Portugal — generally operating as clinics or wellness centres — tend to be small, with most employing fewer than ten people and frequently being run by their founder. Larger integrative wellness facilities do exist in Lisbon and Porto, often serving internationally minded clients with a blend of regulated and unregulated therapies.

Is complementary and alternative medicine regulated in Portugal?

Portugal’s first legislative step toward regulating CAM came in 2003 with Law nº 45/2003, though it took a further decade for the framework to be fully implemented through Law nº 71/2013. During that intervening period, practitioners worked in considerable legal uncertainty, but the current system is now firmly established.

The regulatory foundation for NCT has consistently centred on their complementary relationship to conventional healthcare. The legislation defined the seven NCTs, set minimum standards for practice, delineated each therapy’s scope, placed oversight under the Ministry of Health, established legal accountability and a deontological framework, and mandated training at higher education level. This constitutes a statutory model of regulation — closer in character to the formal professional structures applied to osteopaths and chiropractors in the United Kingdom than to the looser voluntary self-regulation that persists across much of Europe.

The academic threshold for NCT professions was established at bachelor-with-honours level, and the Central Administration of the Health System (ACSS) — responsible for managing the financial, human, infrastructure, and information technology resources of the National Health System — was designated as the body responsible for issuing professional licences.

The legislation sets out six professional profiles covering each alternative medical discipline and stipulates that anyone practising in these fields must have completed third-level or higher education, with specific study areas set out in supplementary legislation. Practising also requires a publicly registered licence, enabling identification of those who hold the necessary qualifications.

Like other regulated health professionals, non-conventional therapists must obtain a professional licence card (cédula profissional) from the ACSS. They are also obliged to register with the ERS (Entidade Reguladora da Saúde — the Health Regulatory Authority) as a health service provider.

Portaria n.º 200/2014 requires non-conventional therapy professionals to maintain civil liability insurance — an important consumer safeguard ensuring that regulated practitioners have cover in place in the event that harm occurs.

In 2015, the Ministries of Health and Education and Science established the general requirements for undergraduate degrees in acupuncture, naturopathy, chiropractic, phytotherapy, and osteopathy, followed in 2018 by corresponding requirements for Traditional Chinese Medicine degrees. The Portuguese Ministry of Higher Education has formally approved only two undergraduate programmes — osteopathy and acupuncture — both offered primarily through private higher education institutions.

Therapies sitting outside the seven regulated NCTs — including reiki, reflexology, hypnotherapy, and Ayurveda — have no dedicated legal framework. Practitioners in these areas are not obliged to hold government-issued licences, which means consumer protections are considerably weaker. It is fair to conclude that Portugal now has relevant legislation but lacks a cohesive overarching policy aimed at systematically developing traditional and complementary medicine.

For the most up-to-date regulatory requirements, including guidance on verifying a practitioner’s credentials, consult the ACSS official page on non-conventional therapies and the ERS website. Requirements can change; always confirm with official authorities for the latest information.

Is CAM covered by health insurance or the public healthcare system in Portugal?

Despite their recognised and regulated status, non-conventional therapies are not offered at National Health Service (SNS) hospitals or clinics, and treatment costs are not reimbursed under standard health insurance arrangements. This is a crucial distinction for expats to grasp: having formal regulatory recognition does not equate to public funding or routine insurance coverage.

Portugal’s public healthcare system, the Serviço Nacional de Saúde (SNS), operates in broadly the same manner as other publicly funded European health systems, providing conventional medical care to residents. However, it extends to none of the seven regulated CAM therapies. Patients who opt for CAM must meet these costs independently, regardless of their entitlement to SNS care.

Some private insurance plans do include therapies such as osteopathy, acupuncture, and homeopathy. However, CAM coverage is far from standard across private health policies in Portugal, and the degree of cover differs substantially between insurers and plan levels. Certain international insurers with more comprehensive offerings also provide benefits for acupuncture and Traditional Chinese Medicine. If CAM coverage matters to you, it is worth explicitly asking insurers about this before committing to a policy, as it is frequently treated as an optional extra rather than a built-in benefit.

Private health networks active in Portugal include Multicare, AdvanceCare, and Medis, among others. Where CAM coverage exists within these networks, it typically requires treatment to be delivered by a practitioner holding a valid cédula profissional. Always verify details directly with your insurer or through the SNS official website, as reimbursement thresholds and included therapies are subject to change.

How much does complementary and alternative medicine cost in Portugal?

CAM services in Portugal are generally more competitively priced than in many other Western European countries or in North America, though costs vary depending on the city, clinic, therapist experience, and type of therapy. The following approximate ranges reflect pricing as of 2024–2025, but should be confirmed directly with practitioners or professional associations, as fees change regularly.

• Acupuncture: Initial consultations typically range from around €40 to €70; subsequent sessions from approximately €35 to €60.
• Osteopathy: Sessions generally fall between €40 and €80 per appointment.
• Chiropractic: Initial assessments tend to be higher, often €50–€90, with follow-up appointments in a similar range to osteopathy.
• Homeopathy: Consultations are typically €40–€70, with first appointments — which are usually longer — at the upper end of this range.
• Phytotherapy / Naturopathy: Consultation fees are broadly in line with homeopathy, though the cost of products may be additional.
• Traditional Chinese Medicine: Consultation and treatment packages vary considerably; a combined consultation and treatment session typically costs €40–€80.

Private medical centres in Portugal generally offer consultation fees in the region of €40 to €50 for standard care. CAM consultations may sit at or above this level depending on the discipline. Prices are generally lower outside Lisbon and Porto, particularly in smaller towns and rural areas. Some practitioners offer discounted packages for multiple sessions, which can reduce the cost per visit. Confirm current fees directly with practitioners or professional associations before making a booking.

How do I find a qualified CAM practitioner in Portugal?

The most dependable approach to locating a regulated CAM practitioner in Portugal is to confirm that they hold a current cédula profissional issued by the ACSS. This requirement applies to all seven regulated NCTs. Guidance on checking the ACSS practitioner database is available at the ACSS Terapêuticas Não Convencionais page.

Regulated practitioners are also required to register with the ERS (Entidade Reguladora da Saúde) as health service providers. You can search for registered health establishments through the ERS website, which maintains a publicly accessible database of authorised health service providers.

Several professional associations represent practitioners within specific therapy areas and can provide referrals to their members. These include:

• APPA-fmtc (Associação Portuguesa de Profissionais e Amigos da Fitoterapia e Medicina Tradicional Chinesa): appa-mtc.org
• IMT – Instituto de Medicina Tradicional: imt.pt
• The Ministério da Saúde website provides links to the consultative councils established for each of the seven therapies: sns.gov.pt

When assessing a practitioner, look for their cédula profissional number displayed clearly on their clinic website or within the consultation space. Ask about their academic background and the institution that awarded their qualification. For therapies falling outside the seven regulated NCTs — such as reiki or reflexology — there is no government licence to check, which makes personal recommendations, voluntary professional association membership, and open communication about training credentials all the more important.

Expats in larger cities are generally better placed to find practitioners who work in languages other than Portuguese. Private clinics in Lisbon, Porto, Cascais, and the Algarve frequently serve international residents, and many practitioners in these areas consult in English. Expat community groups and online forums can be a valuable source of personal referrals, though these should complement — not substitute for — formal verification of credentials.

Exercise caution with any practitioner who makes extravagant health promises, guarantees cures, discourages you from consulting a conventional doctor, or is unable to produce their licence details. Portugal’s ERS accepts formal complaints about health service providers, including CAM clinics, where concerns arise about the quality or safety of care provided.

Are there traditional or indigenous medicine systems practised in Portugal?

Portugal does not have a formally recognised indigenous healing tradition in the way that some nations do — for instance, Ayurveda in India, Traditional Chinese Medicine in China, or Rongoā Māori in New Zealand. Nevertheless, a rich heritage of folk medicine and plant-based healing runs deep within Portuguese rural culture, especially in interior regions, the Alentejo, and island communities in the Azores and Madeira.

The use of herbal preparations, infusions, and plant-derived remedies has historically been widespread among older generations in rural Portugal, typically transmitted through family knowledge rather than through any formal professional structure. Many of these practices share principles with phytotherapy — one of the seven legally recognised NCTs — though they are practised informally and are not separately regulated as a distinct traditional system.

Portugal’s historic ties to its former African, Asian, and South American colonies have also brought healing traditions from those regions into the country. Practices rooted in Brazilian spiritual traditions, African herbal medicine, and East Asian systems such as TCM are all present. In the case of TCM, this is formally encompassed within the NCT legal framework. The Portuguese health system is currently navigating a transition between an inclusive and an integrative model, one that seeks to articulate the relationship between allopathic and traditional and complementary medicine.

None of Portugal’s folk or informal healing traditions are formally regulated or recognised as a distinct system by the state. They remain outside the NCT framework and are not subject to the same quality or safety oversight. Expats curious about these traditions may encounter them in markets offering dried herbs and botanical preparations, in certain pharmacies stocking phytotherapy products, and in naturopathy consultations where traditional plant knowledge overlaps with the regulated professional context.

What should expats know about using CAM alongside conventional medicine in Portugal?

The Portuguese health system is currently navigating a transition between an inclusive and an integrative model, seeking to define the relationship between allopathic medicine and traditional and complementary approaches. In practice, however, meaningful integration of CAM into mainstream clinical care remains limited, and the vast majority of CAM is accessed privately and independently of the SNS.

Conventional medical practitioners in Portugal — particularly those working within the public SNS — are trained within a biomedical framework and do not routinely discuss or refer patients to CAM therapies. Attitudes differ considerably among individual clinicians. Some GPs, especially those in private practice or in urban areas with greater exposure to international health trends, are more receptive to discussing integrative care options. If you are using CAM alongside conventional treatment, it is always prudent to inform your GP or specialist, particularly where the potential for herb-drug interactions exists.

Herb-drug interactions represent a genuine safety concern with phytotherapy and naturopathy in particular. Preparations containing St John’s Wort, for example, are known to interact with anticoagulants, contraceptives, and a range of other medications. Portugal’s national medicines regulator, INFARMED — Autoridade Nacional do Medicamento e Produtos de Saúde, oversees the regulation of herbal medicinal products marketed in Portugal. INFARMED is the National Authority for Medicines and Health Products responsible for the regulatory framework governing medicinal products in Portugal. Their website provides information on licensed herbal products and health product safety. Always confirm that any herbal product you purchase is properly registered and authorised for sale in Portugal.

Certain private hospitals and clinics in Portugal, particularly in Lisbon and Porto, offer integrative medicine consultations where conventional and complementary approaches are considered in tandem. These are private-pay services. If integrative care is a priority, it is worth researching this before settling on a healthcare provider.

When combining CAM with conventional treatment for a serious or ongoing condition, the most important practical steps are:

1. Inform all your healthcare providers — both conventional and CAM — about every treatment, supplement, and herbal product you are currently using.
2. Confirm that your CAM practitioner holds a valid cédula profissional from the ACSS for one of the seven regulated NCTs.
3. Verify that any herbal or health product is authorised for sale in Portugal by consulting the INFARMED database at infarmed.pt.
4. Ask your GP for their clinical view — or a referral where appropriate — before commencing a new CAM treatment, especially if you have a long-term condition or are taking prescription medicines.
5. Keep thorough records of all CAM treatments, products, and practitioners, just as you would with conventional medical care.

Portugal’s Ministry of Health publishes health guidance through the Directorate-General of Health (DGS), accessible at dgs.pt. While patient-specific CAM guidance is limited on this platform, it remains the authoritative source for official public health policy in Portugal. For concerns about the quality or safety of CAM services received, the ERS is the appropriate body to contact.

Frequently asked questions about CAM in Portugal

Are all CAM therapies legal in Portugal?

Seven therapies have been formally legalised: acupuncture, homeopathy, osteopathy, naturopathy, phytotherapy, chiropractic, and Traditional Chinese Medicine. Other modalities — such as reiki, reflexology, hypnotherapy, aromatherapy, and Ayurveda — are neither prohibited nor specifically regulated. Practitioners offering these therapies work without mandatory licensing requirements, which means clients have substantially fewer formal consumer protections when using unregulated therapies.

How do I check whether a CAM practitioner in Portugal is properly licensed?

Practitioners of the seven regulated NCTs must hold a cédula profissional issued by the ACSS. Ask any practitioner offering acupuncture, TCM, osteopathy, chiropractic, homeopathy, naturopathy, or phytotherapy for their licence number, and cross-check it via the ACSS website. Registered health service establishments should also appear on the ERS provider database.

Can I find CAM practitioners in Portugal who speak languages other than Portuguese?

Many health professionals in Portugal have a working command of English, particularly within the private healthcare sector, where fluency is more common. CAM clinics in Lisbon, Porto, Cascais, Sintra, and the Algarve — all areas with established international communities — are more likely to include practitioners who consult in English or other languages. Expat community networks and online forums are a useful starting point for gathering personal recommendations from people in comparable situations.

Is CAM covered by Portugal’s public health system (SNS)?

Non-conventional therapies are not available at SNS hospitals or clinics, and treatment costs are not reimbursed through standard health insurance. This means patients typically bear the full cost of CAM out of pocket. Some private health insurance plans provide partial coverage for selected therapies such as osteopathy or acupuncture — review any policy carefully before purchasing to understand what is included.

Do I need a referral from a conventional doctor to see a CAM practitioner in Portugal?

No referral is needed to consult a regulated CAM practitioner in Portugal — you may book directly with any practitioner who holds a cédula profissional. That said, it is sound practice to keep your GP or specialist informed that you are using CAM, particularly if you are on prescription medication or managing a chronic health condition, in order to minimise the risk of adverse interactions.

Are herbal and homeopathic products regulated in Portugal?

Yes. Herbal medicinal products placed on the Portuguese market must satisfy regulatory requirements administered by INFARMED, the national medicines authority, in accordance with European Union legislation. Products marketed as food supplements rather than medicinal products are subject to different — and typically less stringent — rules. Purchase herbal and homeopathic products from pharmacies or authorised retailers, and use the INFARMED database to confirm the authorisation status of specific products.

How does Portugal’s CAM regulatory system compare to other countries?

Portugal appears to be tracking a convergent course toward NCT regulation relative to other European nations. The statutory licensing model — which demands a degree-level qualification and a government-issued licence — is structurally comparable to the professional regulation of osteopaths and chiropractors in the UK, though Portugal’s system encompasses a wider range of therapies. It is considerably more rigorous than the voluntary self-regulation that remains the norm for many CAM modalities in countries such as Germany or the Netherlands.

What should I do if I have a complaint about a CAM practitioner in Portugal?

Complaints about a regulated CAM practitioner or clinic can be submitted to the ERS (Entidade Reguladora da Saúde), the health regulatory body responsible for overseeing all registered health service providers in Portugal, including CAM establishments. For concerns relating to unlicensed products or unsubstantiated medicinal claims, contact INFARMED. Retain documentation of all consultations, products purchased, and correspondence with the practitioner concerned.