Swiss therapy practices of all professional groups – physiotherapy, osteopathy, occupational therapy, speech therapy, TCM, massage, psychotherapy, and coaching – are permitted to charge no-show fees. The prerequisite is always a transparent agreement in advance (GTC or intake form) and a proportionate fee. The most effective technical implementation is credit card authorization via pre-authorization – for TWINT payers, an alternative solution is required.

This guide summarises the Swiss legal situation, industry-specific characteristics, proportionate fee amounts, and the technical implementation for all therapy professions.

1. Legal Basis: Code of Obligations Art. 160 et seq. and the Contract Upon Appointment Booking

With an appointment booking, a contract is concluded in Switzerland – even without written confirmation, even with a telephone booking. The Code of Obligations (CO) allows two ways to receive money in the event of a breach of contract:

Option 1 – Compensation for damages according to CO Art. 97 et seq.: The practice must prove that the missed appointment led to real financial damage – i.e. that the slot could not be filled otherwise and revenue was lost. This is complex and hardly enforceable in practice.

Option 2 – Contractual penalty according to CO Art. 160 et seq.: The practice agrees in advance on a fixed flat rate that becomes due in the event of non-performance – without proof of damage. Prerequisite: The regulation must have been explicitly agreed upon and accepted during booking or intake. This is the standard path for all therapy practices.

2. Proportionate Fee Amount: What Applies to Which Industry

The fee must be proportionate and reflect the actual loss. There is no legal upper limit. As a rule of thumb: The more difficult it is to fill the slot at short notice, the higher the fee may be. In well-utilized practices that can often fill gaps, the full session price would be difficult to justify.

3. The No-Show Policy: What Must Be in the GTC

A legally compliant no-show policy contains three elements: the cancellation deadline (the latest at which you must cancel), the fee amount (fixed flat rate or percentage), and the exception clause (family emergency, sudden illness). Optional but recommended: a goodwill rule for the first missed session.

Sample phrasing for GTC or intake form: 'For appointment cancellations less than 24 hours before the agreed treatment or in the case of unexcused absence, a cancellation fee of CHF [amount] will be charged. In the event of a proven emergency, the fee is waived. The first missed session remains free of charge.'

Important: The policy must be communicated and accepted before service delivery. This can be done in the GTC agreement during online booking, in the intake form at the initial consultation, or in a separate written agreement. Verbal agreements are difficult to prove.

4. SPO Position and Goodwill: What the Patients' Organisation Recommends

The Swiss Patients' Organisation (SPO) considers no-show fees to be generally permissible, but states clear conditions: The fee must be communicated during booking, must not exceed the actual damage, and goodwill in the case of cancellations through no fault of one's own is strongly recommended.

In practice, a two-stage reaction is recommended: First no-show – friendly enquiry if everything is okay, no fee collection. From the second no-show – fee is collected, with a clearly communicated reason. This strengthens the therapeutic relationship and significantly reduces complaints.

5. Technical Implementation: Pre-Authorization via Payrexx

The most effective technical solution is the credit card guarantee (pre-authorization) during online booking: The patient leaves credit card details without an amount being debited immediately. In the event of a no-show, you debit the agreed fee with just a few clicks in the Payrexx Dashboard – no dunning process, no debt collection necessary.

Payrexx supports pre-authorization for Visa, Mastercard (debit and credit), Apple Pay, Google Pay, and Samsung Pay. TWINT does not support pre-authorization – an alternative is required for TWINT payers.

6. TWINT Alternative: Prepayment with Refund Option

For patients who wish to pay exclusively via TWINT, there is a pragmatic alternative to the credit card guarantee: The patient pays for the session in advance via a TWINT payment link. If they cancel in time (within the agreed period), you refund the full amount – TWINT refunds are possible within 30 days. If they do not show up, you keep the amount according to the no-show policy.

This requires that the no-show policy is clearly communicated in the booking confirmation: 'You pay for the session in advance. If you cancel up to 24 hours beforehand, you will receive an immediate refund. In the case of short-term cancellation or no-show, the cancellation fee applies.'

7. Industry-Specific Characteristics

Psychotherapy

Special ethical dimension: A no-show can be a symptom, not indifference. Goodwill regulation is particularly important. Introduce the credit card guarantee transparently in the intake form. More details in the guide 'No-Show Fees in Psychotherapy'.

Children (OT, Speech Therapy, Child Physio)

The parents are the contracting parties, not the children. The no-show policy must be agreed with the parents. In the event of short-term cancellations due to child illness, goodwill is particularly appropriate – goodwill rule recommended for the first 2–3 cancellations.

OKP-Licensed Practices

No-show fees for services covered by basic health insurance are possible, but the fee cannot be billed via health insurance. Consultation with the professional association (Physioswiss, Occupational Therapy Switzerland, Speech Therapy Switzerland) recommended.

8. Checklist: No-Show Policy for All Therapy Practices

• Formulate no-show policy: cancellation deadline, fee amount, exceptions, first-session-free-of-charge rule

• Integrate policy into GTC or intake form, obtain written consent

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

• For TWINT payers: communicate prepayment with refund option as an alternative

• Adjust booking confirmation: always explicitly mention the no-show policy

• Define goodwill rule internally: when is the fee waived

• Observe first implementation: how do patients react? Adjust policy if necessary

• Annual review: is the fee amount still proportionate and customary in the market?

Payrexx supports pre-authorization for Visa, Mastercard, and Mobile Wallets in all plans incl. Free – no subscription needed for the basic function. In the event of a no-show, you debit the fee with just a few clicks in the Dashboard. For TWINT payers: payment link before the session with refund option. All in one Dashboard, one payout.