The Practical Guide: Payment solutions for psychotherapists and coaches in Switzerland

Psychotherapeutic practices function fundamentally differently in terms of payment than physiotherapy or TCM: psychotherapists approved by the KVG (compulsory health insurance) bill via health insurance and usually do not collect any payments 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 therapeutic setting, and which payment solution fits which situation.

1. The three billing models in Swiss psychotherapy

Model A: Approved psychotherapy under the compulsory health insurance scheme (KVG)

Psychotherapists with KVG approval (i.e. medical psychotherapists or delegated psychotherapy under medical supervision) bill directly via basic insurance. Patients pay the usual deductible (at least EUR 300/year for adults) and the 10% co-payment. These amounts are billed at the end of the quarter or year via the health insurance fund – they are not collected directly on-site. This means: no checkout process in the practice, no terminal required for completing the session.

Model B: Non-approved psychotherapy / self-payers

Psychological psychotherapists without KVG approval – for example, with a master's degree in psychology but without a medical delegation agreement – offer their services as a private service. Patients pay the full session price themselves: typically EUR 130 to EUR 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 generally collect everything directly. Session prices are typically EUR 150 to EUR 350 per hour, with package offers (e.g. 5-session coaching package) ranging from EUR 800 to EUR 2'000. In this segment, advance payment at the time of booking is particularly common – both via payment link and via Payrexx Pages.

2. Why a terminal in the treatment room harms the therapeutic setting

In psychotherapy, the end of a session is a sensitive moment. The conversation ends, often after intense topics, and the therapist accompanies the client to the exit. Presenting 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 wish. This completely decouples payment from the therapeutic setting. For online sessions (Zoom, Teams), the payment link is the only sensible solution anyway.

Another aspect: in group therapy or institutional settings, paying at the terminal can feel socially awkward if 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 process is incredibly simple: conduct the session, conclude the session, leave the practice. Afterwards – either on the same day or the following 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 included in all Payrexx plans, including Free. For practices utilizing exclusively payment links (no terminal, no Tap to Pay), the Free plan is a complete setup with no fixed costs. Transaction fees via the Standard plan: TWINT 1.25% + EUR 0.18, Visa/Mastercard 1.65% + EUR 0.18 (as of May 2026).

For coaching packages: Payrexx Pages

Those who sell coaching packages (e.g. 5-session package, 3-month programme) create a Payrexx Page with the package options once and share the URL on the website or in the appointment confirmation. Clients book and pay in one step. This works without a booking tool plugin and in 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 by 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 by credit card are recommended: the client enters their credit card details once, and the amount is automatically debited after each session. Recurring Payments are available in all Payrexx plans. TWINT does not support Recurring Payments – Visa or Mastercard is required for this.

5. Insurance patients and self-payers simultaneously: separating bookkeeping cleanly

Many psychotherapists have a mixed practice: some patients are KVG-approved (billing via Tarmed), while others pay directly. In the Payrexx Dashboard, all direct payments can be provided with a reference text and exported as a CSV. Recommended convention: 'Self-payer [initials/ID]' vs. 'Coaching [client name]' – this keeps the categorization in the payment solution free from patient details.

Data privacy note: no diagnoses or detailed patient data should be entered as reference text in the Payrexx Dashboard. Payment data and patient data must be kept separate for data protection reasons. The reference text serves internal allocation – initials or a patient ID are sufficient.

6. Cost comparison: what is worth it for a psychotherapy practice?

With 20 sessions/month at EUR 160 via TWINT: Free = EUR 47.60 in fees, Standard = EUR 43.60 + EUR 19 subscription = EUR 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 is worth it. As of May 2026.

7. Checklist: setting up a payment solution for the psychotherapy practice

• Clarify which billing model you use: KVG approved, self-paying, or coaching

• Set up a Payrexx account – the 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 a fixed URL

• For weekly online sessions: set up Recurring Payments with a credit card

• Define reference text convention: initials or patient ID, no diagnoses

• Verify the 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 without a monthly fee is a complete setup for individual practices primarily utilizing payment links.