Physiotherapists in Switzerland are allowed to charge no-show fees – but only if the fee has been communicated transparently in advance, is proportionate, and an actual loss of earnings has occurred. The technically simplest safeguard is pre-authorization via credit card during online booking, combined with a clear no-show policy in the T&Cs.

This guide explains the Swiss legal situation (CO Art. 160 et seq.), shows you how to determine a proportionate fee, and how to technically implement pre-authorization via Payrexx.

1. The problem: Unexcused missed appointments cost real money

A 50-minute physiotherapy appointment that is missed without excuse means a complete loss of performance for the practice without compensation. With a self-payer session price of EUR 120 and ten no-shows per month, this amounts to a monthly revenue loss of EUR 1'200. Added to this is the effort: filling gaps at short notice, following up, and in the worst-case scenario, unpaid reminders for patients who did not show up.

The problem is structural: Anyone who can cancel an appointment free of charge – or simply not show up – has no financial incentive to keep appointments. A clear no-show policy with financial consequences is proven to change behavior.

2. Legal situation: What the Code of Obligations allows

By booking an appointment, a contract is concluded in Switzerland – even without written confirmation. If one party does not comply with the contract, the other party can generally claim damages (CO Art. 97 et seq.). In practice, however, this is difficult to enforce: The practice must prove that the appointment could not be filled otherwise and that an actual loss of income has occurred.

The more elegant solution is the contractual penalty according to CO Art. 160 et seq.: Here, a fixed fee is agreed contractually in advance, which becomes due in the event of non-performance – without proof of damage. This requires a clear agreement that is accepted during booking – e.g., T&C consent in the booking confirmation.

3. What the SPO says about the no-show fee

The Swiss Patient Organisation (SPO) considers no-show fees to be fundamentally permissible, but specifies clear conditions: The fee must have been communicated during booking, must only reflect the actual loss incurred, and must be proportionate. Charging 100% of the session price as a flat rate is only justifiable if it can be proven that the slot could not be filled otherwise.

Goodwill in the event of unexcused cancellations – accident, sudden illness – is explicitly recommended by the SPO. This is not a legal obligation, but a practice that strengthens the relationship of trust with patients in the long term.

4. How high can the fee be?

There is no statutory upper limit. The fee must be proportionate and reflect the actual loss. In practice, the following guide values have become established in Swiss therapy practices:

Important: If the appointment is filled by another person at short notice, no damage has occurred and the fee cannot be claimed. Therefore, document no-shows and whether the slot was filled.

5. Pre-authorization via Payrexx: Technical implementation

Pre-authorization is technically the simplest and most effective method for enforcing no-show fees. During online booking, the patient enters credit card details – no amount is charged immediately. Payrexx reserves the agreed amount on the card. If the person shows up for the appointment, the actual session amount is billed or the reservation is released. If they fail to show up, the no-show fee is charged with just a few clicks in the Dashboard.

Payrexx supports pre-authorization for Visa, Mastercard (debit and credit), Apple Pay, Google Pay, and Samsung Pay. TWINT and PostFinance do not support pre-authorization technically. For patients paying with TWINT, an advance payment with a refund option in case of correct cancellation is recommended.

Step-by-step setup

• Set up a Payrexx account (Standard or Premium for full functionality)

• Configure booking page or payment link with pre-authorization

• Formulate no-show policy in T&Cs: deadline, amount, exceptions

• Integrate T&C consent into the booking process – before completing the booking

• In case of a no-show: charge the reserved fee in the Payrexx Dashboard

• In case of correct cancellation within the deadline: release the reservation, no charge

6. Formulating a no-show policy: Sample text

A legally compliant no-show policy needs three elements: the cancellation deadline, the fee amount, and the exception rule. Sample text for T&Cs:

'In the event of appointment cancellations less than 24 hours prior to the agreed treatment or in the event of unexcused absence, a cancellation fee of EUR [amount] will be charged. In the event of a proven emergency (accident, sudden illness), the fee is waived. The fee will be charged to the credit card on file during booking or sent via invoice.'

You can choose the cancellation deadline (here 24 hours) freely – there is no statutory deadline in Switzerland. 24 to 48 hours are standard in the industry and are perceived as fair by patients.

7. Checklist: Setting up no-show fees in a physiotherapy practice

• Formulate a no-show policy with a cancellation deadline, fee amount, and goodwill rule

• Integrate the policy into the T&Cs and require consent during booking

• Set up pre-authorization in the Payrexx Dashboard (Visa, Mastercard, mobile wallets)

• For TWINT patients: advance payment with refund option as an alternative

• Document every no-show: date, whether slot was filled (yes/no), whether fee was charged (yes/no)

• Define a goodwill rule internally: e.g., first no-show without a fee, from the second with a fee

• Communicate the policy proactively: note in appointment confirmation and on the booking page

• Review annually whether the fee amount is still proportionate

Payrexx supports pre-authorization for all major credit cards as well as Apple Pay, Google Pay, and Samsung Pay.

You store the credit card details during booking and, in the event of a no-show, charge the agreed fee directly in the Dashboard – without manual invoicing and without collection proceedings. Combined with payment links for regular payment after the session, this covers the entire payment workflow.