The practical guide: Payment solutions for psychotherapists and coaches in Switzerland
Psychotherapy practices work differently in terms of payment than other therapies: KVG-authorised psychotherapists bill via health insurance. Self-payers and coaching clients pay directly - most sensibly via payment link after the session, not via a terminal in the treatment room.
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Psychotherapy practices function fundamentally differently in terms of payments than physiotherapy or TCM: Psychotherapists covered by KVG health insurance settle via health insurance and generally collect nothing on site. Self-payers and coaching clients pay the full amount directly – most sensibly via Payment Link after the session, not via a terminal in the treatment room.
This guide explains the different billing models in Swiss psychotherapy, why a terminal in the treatment room harms the setting, and which payment solution fits which situation.
1. The three billing models in Swiss psychotherapy
Model A: Health insurance-covered psychotherapy (KVG)
Psychotherapists with KVG licensing (medical psychotherapists as well as psychological psychotherapists under the prescription model, i.e., by medical prescription) bill directly via basic insurance. Patients pay the usual deductible (at least CHF 300/year for adults) and the 10% co-payment. These amounts are settled at the end of the quarter or year via the health insurance – not collected directly on site. This means: No checkout process in the practice, no terminal needed to conclude the session.
Model B: Non-health insurance-covered psychotherapy / Self-payers
Psychotherapists without KVG licensing – or treatments without medical prescription – offer their services as private services. Patients pay the full session price themselves: typically CHF 130 to CHF 250 per 50-minute session. Some supplementary insurances cover a portion. This share must be collected directly.
Model C: Coaching and counselling
Coaches, life counsellors, and mental trainers are not subject to KVG and fundamentally collect everything directly. Session prices typically range from CHF 150 to CHF 350 per hour, package deals (e.g., 5-session coaching package) from CHF 800 to CHF 2'000. In this segment, prepayment upon booking is particularly widespread – both via Payment Link and via Payrexx Pages.
Billing model | Who pays | Direct payment on site | Recommended Payrexx solution |
KVG health insurance-covered | Health insurance | Deductible/co-payment via insurance | Not necessary / Invoice |
Self-payer psychotherapy | Patient directly | Full session price | Payment Link after session |
Coaching / Counselling | Client directly | Full amount | Payment Link or Pages prepayment |
2. Why a terminal in the treatment room harms the therapeutic setting
In psychotherapy, the conclusion of a session is a sensitive moment. The conversation ends, often after intense topics, and the therapist accompanies the client to the exit. Holding out a terminal, waiting for card payment, printing a receipt – this disrupts the transition and feels clinical. Many psychotherapists describe this as disruptive to the therapeutic relationship.
Payment Links solve this problem structurally: The therapist sends a link via SMS after the session. The client pays at home or on the go, whenever they want. This completely decouples payment and the therapeutic setting. For online sessions (Zoom, Teams), the Payment Link is the only sensible solution anyway.
Another aspect: In group therapies or institutional settings, payment at the terminal can feel socially awkward when other participants are watching. Payment Links enable discreet individual billing, independent of the group setting.
3. Payment Link: The payment workflow for psychotherapy practices
The procedure is remarkably simple: Hold the session, conclude the session, walk out of the practice. Afterwards – either on the same day or the next morning – create a Payment Link in the Payrexx Dashboard and send it via SMS or WhatsApp. The client clicks the link, selects TWINT, card, or mobile wallet, and pays. The payment appears immediately in the Dashboard.
Payment Links are available in all Payrexx plans, including Free. For practices that exclusively use Payment Links (no terminal, no Tap to Pay), the Free plan is a complete setup without fixed costs. Transaction fees via the Standard plan: TWINT 1.25% + CHF 0.18, Visa/Mastercard 1.65% + CHF 0.18 (as of: October 2026).
For coaching packages: Payrexx Pages
Those who sell coaching packages (e.g., 5-session package, 3-month programme) create a Payrexx Page once with the package options and share the URL on the website or in the appointment confirmation. Clients book and pay in one single step. This works without a booking tool plugin and across all plans.
4. Billing online sessions: Zoom, Teams, and co.
Remote psychotherapy and online coaching have established themselves permanently in Switzerland after 2020. For these sessions, the Payment Link is the only practical payment solution. No terminal, no QR code on site – the link is sent via email after the session. Or even more elegantly: in advance, so that the client has already paid before the session begins.
For regular weekly or bi-weekly online sessions, recurring payments with credit card are recommended: The client enters credit card details once, and the amount is debited automatically after each session. Recurring payments are available in all Payrexx plans. TWINT does not support recurring payments – this requires Visa or Mastercard.
5. Insurance patients and self-payers simultaneously: Separating accounting cleanly
Many psychotherapists run a mixed practice: Some patients are covered via basic insurance, others pay directly. In the Payrexx Dashboard, all direct payments can be provided with a booking text and exported as CSV. Recommended convention: 'Self-payer [initials/ID]' vs. 'Coaching [client name]' – this keeps the categorisation free of patient data within the payment solution.
Data privacy note: No diagnoses or detailed patient data should be entered as booking text in the Payrexx Dashboard. Payment data and patient data must be kept separate under data protection law. The booking text serves for internal allocation – initials or a patient ID are sufficient.
6. Cost comparison: What pays off for a psychotherapy practice?
Setup | Monthly fixed costs | Fee CHF 160 TWINT | Fee CHF 160 Visa/MC | Suitable for |
Payrexx Free + Payment Link | CHF 0 | CHF 2.38 (1.30%+0.30) | CHF 4.30 (2.50%+0.30) | Getting started, few transactions |
Payrexx Standard + Payment Link | CHF 19 | CHF 2.18 (1.25%+0.18) | CHF 2.82 (1.65%+0.18) | From approx. 40 sessions/month |
Payrexx Premium + Payment Link | CHF 49 | CHF 2.18 (1.25%+0.18) | CHF 2.34 (1.35%+0.18) | High volume, group practices |
With 20 sessions/month at CHF 160 via TWINT: Free = CHF 47.60 fees, Standard = CHF 43.60 + CHF 19 subscription = CHF 62.60 total. The Free plan is often cheaper than Standard for small practices with few direct payments. From approx. 40 direct sessions/month, Standard pays off. As of: October 2026.
7. Checklist: Setting up a payment solution for the psychotherapy practice
Clarify which billing model you use: KVG health insurance-covered, self-payer, or coaching
Set up your Payrexx account – Free plan is sufficient for Payment Links and recurring payments
Create a Payment Link template for the standard session price (under 1 minute in the Dashboard)
Activate TWINT and credit card as payment methods
For coaching packages: Set up a Payrexx Page with package options and fixed URL
For weekly online sessions: Set up recurring payments with credit card
Establish a booking text convention: Initials or patient ID, no diagnoses
Review privacy policy for payment processing (FADP Art. 9, DPA with Payrexx)
Payrexx offers psychotherapists and coaches Payment Links, recurring payments, Payrexx Pages, and Invoice from a single account – with TWINT, credit card, and mobile wallets without separate contracts. The Free plan with no monthly fee is a complete setup for solo practices mainly using Payment Links.
Frequently asked questions about payment solutions in psychotherapy and coaching
As a health insurance-approved psychotherapist, do you need a payment solution?
No, not for billing sessions through basic insurance. A payment solution makes sense for self-paying clients, services not covered by health insurance, or if you offer coaching in parallel.
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Why is a terminal in psychotherapy problematic?
A terminal at the end of an intensive session disrupts the therapeutic setting. Payment links decouple payment and therapy – your client pays discretely after the session.
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Can coaching packages be prepaid?
Yes. With Payrexx Pages or a payment link with the package amount, the full package fee can be collected before the first session.
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Which payment methods can you use for recurring payments?
Recurring payments work with Visa and Mastercard. TWINT does not support recurring payments as TWINT does not support tokenisation.
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Is the Free plan or Standard plan worth it for a small psychotherapy practice?
With fewer than approx. 40 direct sessions per month, the Free plan is cheaper. Above that, Standard is worth it due to lower transaction fees.
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How do you protect patient data in the payment solution?
Payment data and patient data must remain separate. No diagnoses as booking reference. Payrexx is PCI DSS certified and does not store credit card numbers in plain text.
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