No-show fees in physiotherapy: What is allowed in Switzerland and how you implement it

Physiotherapists in Switzerland are permitted to charge no-show fees – but only if the fee has been transparently communicated in advance, is proportionate, and an actual loss has occurred. The technically simplest safeguard is pre-authorisation 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 you technically implement pre-authorisation via Payrexx.

1. The problem: Unexcused missed appointments cost hard cash

A 50-minute physiotherapy appointment that is missed without an 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, that amounts to a revenue loss of CHF 1,200 monthly. Added to this is the effort involved: filling gaps at short notice, following up, and in the worst case, unpaid payment reminders for patients who did not appear.

The problem is structural: Anyone who can cancel an appointment free of charge – or simply not show up – has no financial incentive to keep the appointment. A clear no-show policy with financial consequences demonstrably changes behaviour.

2. Legal situation: What the Swiss Code of Obligations allows

In Switzerland, a contract is concluded upon booking an appointment – even without written confirmation. If one party fails to honour the contract, the other party can fundamentally claim compensation for 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 revenue occurred.

The more elegant solution is a contractual penalty under CO Art. 160 et seq.: In this case, 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 accepted at booking – e.g. T&C consent 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 fundamentally permissible, but specifies clear conditions: The fee must have been communicated at booking, may only reflect the loss actually incurred, and must be proportionate. A flat-rate 100% charge of the session price is only justifiable if the slot demonstrably could not be filled otherwise.

The SPO expressly recommends goodwill in cases of unpreventable cancellations – accidents, sudden illness. This is not a legal obligation, but a practice that strengthens the relationship of trust with patients in the long run.

4. How high may the fee be?

There is no statutory upper limit. The fee must be proportionate and reflect the actual loss. In practice, the following benchmarks have become customary among Swiss therapy practices:

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

5. Pre-authorisation via Payrexx: Technical implementation

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

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

Step-by-step setup

• Set up a Payrexx account (pre-authorisation is available in all plans including Free)

• Configure booking page or Payment Link with pre-authorisation

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

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

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

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

6. Formulating a no-show policy: Sample text

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

'For appointment cancellations less than 24 hours prior to 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 is waived. The fee will be debited via the credit card provided during booking or issued by invoice.'

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

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

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

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

• Set up pre-authorisation in the Payrexx Dashboard (Visa, Mastercard, mobile wallets)

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

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

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

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

• Review annually whether the fee amount remains proportionate

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

You store the credit card details upon booking and, in the event of a no-show, debit the agreed fee directly in the Dashboard – without manual invoicing and without debt collection proceedings. Combined with Payment Links for regular payment after the session, this covers the entire payment workflow.