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

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

1. Legal basis: CO Art. 160 et seq. and the contract at the time of appointment booking

In Switzerland, an appointment booking constitutes a contract – even without written confirmation, even with telephone bookings. 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 unused appointment resulted in actual financial loss – i. e. that the slot could not be filled otherwise and revenue was lost. This is costly and hardly enforceable in practice.

Option 2 – Contractual penalty according to CO Art. 160 et seq.: The practice agrees upfront on a fixed flat fee that becomes due in case of non-performance – without proof of damages. Prerequisite: The rule must have been explicitly agreed upon and accepted during booking or intake. This is the standard procedure 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 highly frequented practices that can often fill gaps, the full session price would be difficult to justify.

3. The cancellation policy: What needs to be in the GTCs

A legally compliant no-show policy includes three elements: the cancellation deadline (what is the latest point to cancel), the fee amount (fixed flat fee or percentage), and the exemption rule (family emergency, sudden illness). Optional but recommended: a goodwill rule for the first missed session.

Sample wording for GTCs or intake form: 'For appointment cancellations less than 24 hours before the agreed treatment or in case of unexcused absence, a cancellation fee of EUR [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 services are provided. This can take place during the GTCs approval during booking online, in the intake form at the first session or in a separate written agreement. Verbal agreements are difficult to prove.

4. SPO position and goodwill: What the patient organisation recommends

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

In practice, a two-stage response 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-authorisation via Payrexx

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

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

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 using 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 appear, you retain the amount in accordance with the cancellation policy.

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

7. Industry-specific special features

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 can be found in the guide 'No-Show Fees in Psychotherapy'.

Children (OT, speech therapy, children's physio)

The parents are contractual partners, not the children. The cancellation policy must be agreed upon with the parents. In the event of short-term cancellations due to a child's illness, goodwill is particularly appropriate – a goodwill rule for the first 2-3 cancellations is recommended.

Practices with KVG health insurance approval

No-show fees for services covered by 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) is recommended.

8. Checklist: No-show policy for all therapy practices

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

• Integrate the policy into the GTCs or intake form, obtain written consent

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

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

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

• Record goodwill rule internally: When is the fee waived

• Monitor initial implementation: How do patients react? Adjust policy if necessary

• Annual review: Is the fee amount still proportionate and customary for the market?

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