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 (GTC or admission declaration) and a proportionate fee. The most effective technical implementation is the credit card guarantee via pre-authorization – an alternative solution is required for TWINT payers.

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

1. Legal Basis: CO Art. 160 et seq. and the Contract upon Booking an Appointment

In Switzerland, a contract is concluded when an appointment is booked – even without written confirmation, even in the case of booking by phone. The Code of Obligations (CO) allows two ways to receive money in the event of a breach of contract:

Way 1 – Compensation for damages according to CO Art. 97 et seq.: The practice must prove that the missed appointment resulted in real financial damage – i.e. that the slot could not be filled otherwise and revenue was lost. This is tedious and hardly enforceable in practice.

Way 2 – Contractual penalty according to CO Art. 160 et seq.: The practice agrees on a flat rate in advance, which becomes due in the event of non-performance – without proof of damage. Prerequisite: The rule must have been explicitly agreed upon and accepted during booking or admission. This is the standard path 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 can be. In well-utilised practices that can often fill gaps, charging the full session price would be difficult to justify.

3. The No-Show Policy: What Belongs in the GTC

A legally compliant no-show policy contains three elements: the cancellation period (by when the cancellation must be made at the latest), the fee amount (flat rate or percentage), and the exception clause (family emergency, sudden illness). Optional but recommended: a goodwill rule for the first missed session.

Sample formulation for GTC or admission declaration: 'For cancellations made less than 24 hours before the arranged treatment or in the case of unexcused absence, a cancellation fee of EUR [amount] will be charged. In the event of a proven emergency, the fee will be waived. The first missed session remains free of charge.'

Important: The policy must be communicated and accepted before the service is provided. This can be done via the GTC agreement during the online booking, in the admission declaration during the initial consultation, or in a separate written agreement. Verbal agreements are difficult to prove.

4. SPO Position and Goodwill: What the Patient Organisation Recommends

The Swiss Patient Organisation (SPO) considers no-show fees to be fundamentally permissible, but lists clear conditions: The fee must have been communicated during booking, must not exceed the actual damage, and goodwill for cancellations made through no fault of one's own is explicitly recommended.

In practice, a two-stage response is recommended: First no-show – friendly enquiry if everything is alright, no fee charged. From the second no-show onwards – fee will be charged, with a clearly communicated reason. This strengthens the therapeutic relationship and significantly reduces complaints.

5. Technical Implementation: Pre-Authorization via Payrexx

The most effective technical solution is the credit card guarantee (pre-authorization) during online booking: The patient stores credit card details without an amount being debited immediately. In the event of a no-show, you debit the agreed fee with just a few clicks in the Payrexx Dashboard – no dunning process, no debt enforcement law necessary.

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

6. TWINT Alternative: Prepayment with Refund Option

For patients who wish to pay exclusively by TWINT, there is a pragmatic alternative to the credit card guarantee: The patient pays for the session in advance via 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 no-show policy.

This requires that the no-show policy is clearly communicated in the booking confirmation: 'You pay for the session in advance. In the event of cancellation up to 24 hours beforehand, you will be refunded immediately. In the event of a short-notice cancellation or no-show, the cancellation fee applies.'

7. Industry-Specific Peculiarities

Psychotherapy

Special ethical dimension: A no-show can be a symptom, not indifference. Goodwill rule is particularly important. Introduce the credit card guarantee transparently in the admission declaration. More details in the guide 'No-show fees in psychotherapy'.

Children (OT, SLT, Child Physio)

The parents are the contractual partners, not the children. The no-show policy must be agreed upon with the parents. In the case of short-notice cancellations due to a child's illness, goodwill is particularly appropriate – a goodwill rule for the first 2–3 cancellations is recommended.

KVG-Accredited Practices

No-show fees for services covered by the basic health insurance are possible, but the fee cannot be billed through the 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 period, fee amount, exceptions, first-session-free rule

• Integrate policy in GTC or admission declaration, obtain written consent

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

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

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

• Define goodwill rule internally: When is the fee waived

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

• Annual review: Is the fee level still proportionate and in line with market rates?

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