How does the psychotherapy prescription model work?

In 2022, a new regulation regarding the prescription model in psychotherapy came into effect. This decision notably allowed for better integration of psychologists and psychotherapists into the healthcare system. But what are the conditions? OneDoc helps you understand the details.

A Necessary Change: The Prescription Model

As of July 1, 2022, the principle of psychotherapy prescription—similar to that of physiotherapists—was recognized in Switzerland. This decision reflects a significant acknowledgment of the work performed by mental health professionals. Psychologists and psychotherapists can now bill their services directly to the mandatory health insurance as independent practitioners.

This prescription model addresses a genuine need in the Swiss population, with 15% of people already experiencing psychological distress in 2017. These figures have increased following the coronavirus pandemic. It is estimated that over the course of a year, up to one-third of the Swiss population is affected by a mental health condition, the majority of which require treatment.

The shift from the delegation model to the prescription model aims to improve care for children, adolescents, and adults in crisis or emergency situations. Swiss patients will therefore have easier and faster access to psychotherapy. As a result, therapies conducted by psychologists or psychotherapists will be covered by basic health insurance. However, certain conditions must be met.

Conditions for Reimbursement of Psychotherapy Prescriptions

There are the conditions that must be met for the prescription to be reimbursed by health insurance:

1. The prescription must be written by a physician, who can be either a family doctor or a psychiatrist.
2. The prescription must be justified by the presence of a condition recognized by international systems (such as those listed in the WHO’s ICD-10).
3. A maximum of 15 sessions can be billed per prescription. Beyond 30 sessions, the insurer must be consulted to extend the therapy.
4. The psychotherapist must be federally recognized.

Sources:

• Federal Council improvement of access to psychotherapy
• État de santé – OFS
• CIM-10 – WHO