Card payment in the physiotherapy and osteopathy practice: How it works in Switzerland

Swiss physiotherapy and osteopathy practices collect franchise shares, deductibles, and services not covered by health insurance directly from patients - typically EUR 10 to EUR 150 per session. POS terminal, Tap to Pay on an Android smartphone, or payment link via WhatsApp are the three practical solutions, which differ depending on the practice structure and workflow.

This guide shows you which payment flows actually occur in Swiss physiotherapy and osteopathy practices, which amounts are collected directly, and which solution fits your practice.

1. Who pays what - and why outstanding balances are a problem

Billing in physiotherapy in Switzerland is divided into three parts: The mandatory health insurance (OKP, also KVG) covers medically prescribed physiotherapy - but not fully. Patients pay an annual franchise (adults at least EUR 300, selectable up to EUR 2'500) as well as a deductible of 10% of the costs after deducting the franchise. These amounts are not covered by health insurance and must be paid directly to the practice.

For private patients without a medical prescription - for example, for sports massages or preventive treatments - the full session price of typically EUR 90 to EUR 150 is due directly. In osteopathy practices, this share is even higher, as osteopathy is only billed via supplementary insurance. Anyone without supplementary insurance pays the full amount themselves.

The structural problem: Many practices issue paper invoices with a 30-day payment term for deductibles and direct payments. This leads to outstanding balances, dunning runs, and time expenditure. If payments are collected directly after the session via card, TWINT, or payment link, this effort is eliminated.

2. Which payment methods Swiss patients expect

With over 4 million active users, TWINT is the most widely used mobile payment method in Switzerland and is particularly popular in therapy practices. Debit cards - nowadays Visa Debit and Mastercard Debit, formerly Maestro - are standard. The Maestro card has been gradually replaced by Visa Debit and Mastercard Debit since 2023; these work without problems on any modern terminal.

PostFinance Card is still widespread in German-speaking Switzerland, especially among older patients. According to the payment methods survey by the Swiss National Bank (SNB), the cash share in payments has fallen below 40%. Credit cards are used less frequently, but are relevant for higher amounts from private patients.

3. POS terminal, Tap to Pay or payment link: What fits the physiotherapy practice?

There are three practical payment solutions from Payrexx for physiotherapy and osteopathy practices, which can be combined.

POS terminal at the reception

A physical card terminal - the Nexgo N6 or N86 at Payrexx - is suitable for practices with a reception or entrance area. Patients pay directly at the reception when leaving. The regular rental price is EUR 25 per month; currently, N6 and N86 are available for free, while stocks last. POS requires at least the Standard plan (EUR 19/month). The terminal accepts cards, TWINT, Apple Pay, Google Pay, and Samsung Pay.

Tap to Pay on an Android smartphone

Payrexx Tap to Pay turns a compatible Android smartphone (Android 8.1 or higher, NFC-enabled) into a payment terminal - without a separate device. The Payrexx Tap to Pay app is installed on the Android device and connected to the Payrexx account. Patients hold their card, TWINT, or wallet to the smartphone. Tap to Pay is available in every Payrexx subscription, including the Free plan. Transaction fees are identical to the POS terminal: Debit 0.95% + EUR 0.15, Credit 1.25% + EUR 0.15, TWINT 1.25% + EUR 0.00. Important: Tap to Pay currently only works on Android devices, not on iPhones.

Payment link after the session

A payment link is created directly in the Payrexx Dashboard and sent to the patient via SMS or WhatsApp. The patient pays on their smartphone using their preferred payment method. Ideal if there is no reception, the amount is only determined after the treatment, or the therapist wants to bill directly from the treatment room without a physical payment process. Payment links work in every plan including Free.

4. Online booking and prepayment: Prevent outstanding balances structurally

If you link appointment booking and payment, you solve the dunning problem at its root. Patients book online and either make a prepayment or store credit card details for a potential no-show fee. Payrexx offers payment links and hosted payment pages for this workflow, which you can integrate into booking confirmation emails or booking tools.

For series, prepayment of the deductible share at the beginning is recommended: 10 sessions at EUR 100 KVG rate result in EUR 100 deductible in total - collected as prepayment via payment link, any further payment step is eliminated. For private patients with flat-rate prices (e.g. 5 sessions at EUR 120 = EUR 600), the series prepayment improves liquidity and creates commitment.

5. Costs: What a transaction in a physiotherapy practice actually costs

The transaction fees at Payrexx for POS and Tap to Pay are identical regardless of the chosen plan. Differences exist in online fees (for payment links). For comparison with SumUp, the most common competitor for small practices:

Example calculation: EUR 120 session (private patient), Payrexx, Mastercard Debit: 0.95% × 120 = EUR 1.14 + EUR 0.15 fixed = EUR 1.29 fee. Net receipt: EUR 118.71. With 80 such transactions per month: EUR 103.20 fees + EUR 19 subscription (Standard) = EUR 122.20 total costs. Postage and time expenditure for 80 paper invoices clearly exceed this amount.

6. Checklist: Setting up card payments in physiotherapy and osteopathy practices

• Clarify which amounts you collect directly: franchise share, deductible 10%, private patients, services not covered by health insurance

• Choose the suitable solution: POS terminal (reception), Tap to Pay Android (flexible), payment link (without device) or combination

• Order POS terminal only with Standard or Premium plan - Free plan is sufficient for Tap to Pay and payment link

• Download the Payrexx Tap to Pay app onto an Android device (Android 8.1+, NFC) if no terminal is desired

• Set up TWINT as a second payment method - indispensable for Swiss patients

• Inform patients actively: note in appointment confirmation and signs in the reception area

• If possible, link appointment booking with payment or credit card guarantee for no-show protection

• Test all payment methods internally before going live - including TWINT and debit card

Payrexx offers physiotherapy and osteopathy practices POS terminal, Tap to Pay, and payment links from a single account. You sign one contract and accept TWINT, debit card, credit card, and mobile wallets - with a consolidated payout report per week or month.