How does the psychotherapy prescription model work?

The prescription model refers to the system in which a recognized psychologist-psychotherapist can provide and bill psychotherapy services covered by the MHI, provided they are prescribed by a medical doctor.

These foundations ensure a uniform framework across Switzerland while allowing cantons certain competences in admission and pricing.

Until 2022, psychotherapists practiced under the so-called delegation model: they worked under the responsibility of a psychiatrist, who handled the billing. With the prescription model, each authorized psychotherapist now bills independently, while still collaborating with a prescribing physician.

The process follows a clear framework:

1. First prescription: The prescribing physician issues a prescription for 15 psychotherapy sessions.
2. Second prescription: Before the end of the first 15 sessions (around the 12th), a discussion takes place between the psychotherapist and the prescribing physician to validate an additional 15 sessions.
3. Case evaluation after 30 sessions: The psychotherapist prepares a report and sends it to the prescribing physician, who forwards it to a psychiatrist (unless they are one themselves) for case evaluation.
4. Continuation request: The prescribing physician submits the full file to the health insurance provider to request coverage approval.
5. Decision by the health insurer: The insurer determines whether and how many additional sessions will be covered. A new request must be submitted each time the coverage approval expires.

To prescribe psychotherapy sessions, one must be:

• Psychiatrist
• Psychotherapist (for adults or children/adolescents)
• General practitioner
• Other physicians authorized under Art. 38 HIAO

To bill psychotherapy sessions to the MHI, one must be a psychotherapist and meet several requirements:

• Hold a Master’s degree in Psychology from a Swiss university
• Have completed or be enrolled in an accredited postgraduate psychotherapy training
• Hold a cantonal license to practice and a cantonal authorization to bill under the MHI
• Be registered in the Federal Register of Psychology Professions (PsyReg)
• Possess an RCC number issued by SASIS AG

If you are a psychotherapist in training, you may also bill, but only if you are employed by an organization and under qualified supervision.

It should be noted that psychotherapists who were already practicing before the model’s introduction could benefit from transitional rules: admission to the MHI was possible if they could prove at least 3 years of supervised clinical experience after postgraduate training.

To bill according to the correct tariff (PsyTarif), you can choose from different medical software solutions, including the one offered by the Doctors’ Association.

The provisional hourly rate for psychotherapy covered by the basic insurance is set at 154.80 CHF. This value was set by the Federal Council, but cantons may adapt it as needed.You may also bill services through supplementary insurance (VHI), but it is not possible to combine MHI and VHI for the same treatment. You must choose one billing method.

The prescription model in psychotherapy represents a significant step forward for the profession and access to care in Switzerland. It offers psychotherapists greater autonomy and recognition while strengthening collaboration with physicians.