Physiotherapists in Switzerland are allowed to charge no-show fees – but only if the fee has been transparently communicated in advance, is proportionate, and an actual cancellation has occurred. The technically simplest safeguard is pre-authorization via credit card during online booking, combined with a clear no-show policy in the T&Cs.

This guide explains the Swiss legal situation (CO Art. 160 et seq.), shows you how to determine a proportionate fee and how to technically implement pre-authorization via Payrexx.

1. The problem: Unexcused missed appointments cost real money

A 50-minute physiotherapy appointment that is missed without excuse means a complete loss of service for the practice without compensation. With a self-payer session price of CHF 120 and ten no-shows per month, this amounts to CHF 1'200 in lost revenue monthly. On top of that comes the effort: filling gaps at short notice, following up, and in the worst case, unpaid reminders for patients who did not show up.

The problem is structural: Anyone who can cancel an appointment for free – or simply not show up – has no financial incentive to keep appointments. A clear no-show policy with financial consequences has been proven to change behaviour.

2. Legal situation: What the Code of Obligations allows

By booking an appointment, a contract is concluded in Switzerland – even without written confirmation. If one party does not comply with the contract, the other side can generally claim damages (CO Art. 97 et seq.). In practice, however, this is difficult to enforce: The practice must prove that the appointment could not be filled otherwise and that an actual loss of income has occurred.

The more elegant solution is the contractual penalty according to CO Art. 160 et seq.: Here, a fixed fee is contractually agreed in advance, which becomes due in the event of non-performance – without proof of damage. This requires a clear agreement that is accepted during booking – e.g. consent to terms and conditions in the booking confirmation.

3. What the SPO says about the no-show fee

The Swiss Patient Organisation (SPO) considers no-show fees to be generally permissible, but specifies clear conditions: The fee must have been communicated during booking, may only reflect the actual loss incurred, and must be proportionate. A flat-rate 100% billing of the session price is only justifiable if it can be proven that the slot could not be filled otherwise.

The SPO explicitly recommends goodwill in the event of unpreventable cancellations – accident, sudden illness. This is not a legal obligation, but a practice that strengthens the relationship of trust with patients in the long term.

4. How high can the fee be?

There is no legal upper limit. The fee must be proportionate and reflect the actual loss. In practice, the following guide values have become established among Swiss therapy practices:

Important: If the appointment is filled by another person at short notice, no damage has occurred and the fee cannot be claimed. Therefore, document no-shows and whether the slot was filled.

5. Pre-authorization via Payrexx: Technical implementation

Pre-authorization is technically the simplest and most effective method for enforcing no-show fees. When booking online, the patient provides credit card details – no amount is charged immediately. Payrexx reserves the agreed amount on the card. If the person shows up for the appointment, the actual session amount is debbed or the reservation is released. If they fail to appear, the no-show fee is charged with a few clicks in the Dashboard.

Payrexx supports pre-authorization for Visa, Mastercard (debit and credit), Apple Pay, Google Pay, and Samsung Pay. TWINT and PostFinance do not support pre-authorization technically. For patients paying with TWINT, prepayment with a refund option in the event of correct cancellation is recommended.

Step-by-step setup

• Set up a Payrexx account (Standard or Premium for full functionality)

• Configure booking page or payment link with pre-authorization

• Formulate no-show policy in T&Cs: deadline, amount, exceptions

• Integrate T&Cs consent into the booking process – before completing the booking

• In case of a no-show: charge the reserved fee in the Payrexx Dashboard

• In case of correct cancellation within the deadline: release reservation, no charge

6. Formulating a no-show policy: Sample text

A legally secure no-show policy needs three elements: the cancellation deadline, the fee amount, and the exception rule. Sample text for T&Cs:

'For appointment cancellations less than 24 hours before the agreed treatment or in case of unexcused absence, a cancellation fee of CHF [amount] will be charged. In the event of a proven emergency (accident, sudden illness), the fee will be waived. The fee will be charged to the credit card provided during booking or sent via invoice.'

You can choose the cancellation deadline (24 hours here) freely – there is no legal deadline in Switzerland. 24 to 48 hours are industry standard and are perceived as fair by patients.

7. Checklist: Setting up no-show fees in your physiotherapist practice

• Formulate a no-show policy with cancellation deadline, fee amount, and goodwill rule

• Integrate the policy into T&Cs and require consent during booking

• Set up pre-authorization in the Payrexx Dashboard (Visa, Mastercard, Mobile Wallets)

• For TWINT patients: prepayment with refund option as an alternative

• Document every no-show: date, slot filled yes/no, fee charged yes/no

• Define an internal goodwill rule: e.g. first no-show without fee, second with fee

• Communicate the policy proactively: note in appointment confirmation and on the booking page

• Check annually whether the fee amount is still proportionate

Payrexx supports pre-authorization for all major credit cards as well as Apple Pay, Google Pay, and Samsung Pay.

You store the credit card details during booking and, in the event of a no-show, charge the agreed fee directly in the Dashboard – without manual invoicing and without reminder procedures. Combined with payment links for regular payment after the session, this covers the entire payment workflow.