The billing of physiotherapy services in Switzerland can quickly become a real headache. Between the various tariff systems—LAMal (code 312), accident insurance (AA), disability insurance (AI), or military insurance (AM, code 311)—and the multiple tariff positions, it is essential to understand how the tariff navigator works to bill correctly. In this guide, you will find everything you need to know to correctly apply physiotherapy rates.
Prerequisites before billing at the physiotherapy rate (312 or 311)
Before any billing, certain conditions must be met. They ensure that your services comply with the requirements of LAMal and other social insurances:
- You must be LAMal-approved, have an RCC number, and be authorized to practice in your canton.
- Your patient must have a valid medical prescription for any LAMal-covered treatment.
- The number of initially prescribable sessions is limited to 36 sessions. Beyond that, a medical report must be submitted to the insurance for extension.
- The note “Home treatment” must appear explicitly if a home visit is required.
In addition, in Switzerland, LAMal requires that any reimbursed service must be:
- Effective, meaning based on proven evidence and results.
- Appropriate, adapted to the patient’s condition.
- Economical, without excess or redundancy.
Compliance with the EAE principle is verified through your records: initial assessment, measurable therapeutic goals, and justification of chosen techniques.
For AA/AM/AI, the service must correspond to a declared case of accident, service, or disability.
How to bill physiotherapy services under LAMal (Tariff Code 312)?
LAMal services are based on flat-rate billing per session. Each tariff position corresponds to a specific type of treatment.
| Position | Description | Points |
|---|---|---|
| 7301 | General physiotherapy (standard individual session) | 48 |
| 7311 | Complex physiotherapy (neurological disorders, severe respiratory conditions, children <6 years, etc.) | 77 |
| 7330 | Group therapy (2 to 5 patients) | 25 |
| 7350 | Supplement for the first session | 25 |
Only one main position per session is allowed (e.g., 7301 or 7311), with the option to add certain supplements such as 7350.
How to bill physiotherapy services under AA, AM, and AI (Tariff Code 311)?
The tariff logic is similar to LAMal, but the point value is set at 1.00 CHF throughout Switzerland.
Note that starting from July 1, 2025, the new agreement introduces, among other things, billing in 5-minute increments (instead of per session).
Our solutions to reduce administrative time
Using the physiotherapy tariff navigator: step-by-step guide
The tariff navigator (such as that of Physioswiss or OneDoc) allows you to select the correct tariff combination based on the insurance system and treatment conditions. Here’s how to use it:
1. Identify the applicable system
Determine whether the patient falls under:
- LAMal (312) → standard medical prescription → physiotherapy for illness
- AA/AM/AI (311) → accident, disability, or military case → physiotherapy for accident
2. Configure the navigator
- Enter the point value (for LAMal (312) invoices)
- Select the type of treatment: individual, complex, group.
- Specify the location: practice, home, nursing home.
3. Choose the correct position
- 7301 for a general case.
- 7311 for a complex case (with clinical justification and precise diagnosis).
- 7330 for group sessions.
- Applicable supplements: first session (7350), travel.
4. Your software generates a compliant invoice.
- Based on this information, your software calculates the amount and sends the third-party payer invoice directly to the insurer.
7 common billing errors in physiotherapy services (and how to avoid them)
- Incomplete prescription: Make sure the prescription includes all required information (precise diagnosis, treatment goals, and expected duration).
- Incorrect billing of travel allowances in medical-social facilities: Travel allowances can only be billed when treatment is carried out at home, with an explicit medical prescription mentioning “Home treatment.” Check specific conditions before billing.
- Improper use of tariff position 7311: Reserve this position for cases meeting defined complexity criteria, such as severe neurological conditions. It cannot be used to justify treatment duration or specific equipment. The medical diagnosis must clearly indicate the case’s complexity to justify this position.
- Incorrect billing of materials under LiMA and tariff position 7361: Materials used must be billed according to the guidelines of the List of Means and Appliances (LiMA).
- Failure to meet EAE criteria (Effectiveness, Appropriateness, Economy): Ensure each treatment meets all three criteria to guarantee insurance coverage.
- Duplicate prescriptions: If two prescriptions cover the same condition, check whether they complement or overlap. In case of doubt, contact the insurance company for clarification.
- Document thoroughly to bill correctly: Accurate and regular documentation is essential to avoid insurance disputes. Participate in LeDa data collections organized by Physioswiss—they provide the official basis for service justification and secure your billing.
Make your life easier: Choose an automated tariff management solution
To simplify your billing process even further, consider using an automated solution—this way, you don’t have to worry about tariff updates and can easily find the correct rate!
- Automatic tariff updates: Ensure your billing always reflects the latest valid rates.
- Reduced errors: Minimize billing mistakes thanks to built-in validation checks.
- Administrative time savings: Spend less time on paperwork and more with your patients.
And that’s it! You now know everything you need about billing as a physiotherapist!
