No-show fees in physiotherapy: What is allowed in Switzerland and how you implement it

Physiotherapists in Switzerland are allowed to charge no-show fees – but only if the fee was communicated transparently in advance, is proportionate, and an actual loss was incurred. The technically simplest protection is pre-authorization via credit card during online booking, combined with a clear no-show policy in the terms and conditions.

This guide explains the Swiss legal framework (CO Art. 160 et seq.), shows you how to set 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 an excuse represents a complete loss of service without compensation for the practice. With a self-payer session price of EUR 120 and ten no-shows per month, this equals a EUR 1,200 loss in revenue every month. Added to this is the effort involved: filling gaps at short notice, following up, and in the worst case, unpaid reminders for patients who did not appear.

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

2. Legal Situation: What the Code of Obligations Allows

In Switzerland, booking an appointment creates a contract – even without written confirmation. If one party breaches 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 revenue occurred.

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

3. What the SPO Says About No-Show Fees

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

The SPO expressly recommends goodwill in the event of unpreventable cancellations – accident, sudden illness. This is not a legal obligation, but a practice that strengthens the relationship of trust with patients in the long term.

4. How High May the Fee Be?

There is no statutory maximum limit. The fee must be proportionate and reflect the actual loss. In practice, the following benchmarks have become standard among 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 the technically simplest and most effective method for enforcing no-show fees. During online booking, the patient provides credit card details – no amount is charged immediately. Payrexx reserves the agreed amount on the card. If the person attends the appointment, the actual session amount is debited or the reservation is released. If they fail to attend, 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 technically support pre-authorization. For patients paying via TWINT, prepayment with a refund option upon timely cancellation is recommended.

Step-by-Step Setup

• Set up a Payrexx account (pre-authorization is available in all plans, including Free)

• Configure the booking page or payment link with pre-authorization

• Formulate the no-show policy in the terms and conditions: deadline, amount, exceptions

• Integrate consent to terms and conditions into the booking process – before completing the booking

• In the event of a no-show: debit the reserved fee in the Payrexx Dashboard

• In the event of a timely cancellation within the deadline: release reservation, no charge

6. Formulating a No-Show Policy: Sample Text

A legally compliant no-show policy requires three elements: the cancellation deadline, the fee amount, and the exception clause. Sample wording for terms and conditions:

'For appointment cancellations less than 24 hours prior to the agreed treatment or in case of unexcused non-attendance, a cancellation fee of EUR [Amount] will be charged. In the event of a verified emergency (accident, sudden illness), the fee will be waived. The fee will be charged to the credit card provided upon booking or sent via invoice.'

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

7. Checklist: Setting up No-Show Fees in the Physiotherapy Practice

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

• Integrate the policy into the terms and conditions and require consent during booking

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

• For TWINT patients: prepayment with refund option as an alternative

• Document every no-show: date, slot refilled yes/no, fee charged yes/no

• Define an internal goodwill rule: e.g., first no-show without a fee, fee applies from the second

• Communicate the policy proactively: note upon 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 upon booking and debit the agreed fee directly in the Dashboard in the event of a no-show – without manual invoicing and without debt collection proceedings. Combined with payment links for the regular payment after the session, this covers the entire payment workflow.