By Anne T. T. · Published April 12, 2026 · 7 min read
If you run an independent practice, you know the situation: a patient doesn't show up, without warning. The slot is lost, impossible to reassign. And the same question comes back every time — can I bill for this missed session?
The short answer: yes, under certain conditions. But between the legal framework, tariff rules and the therapeutic relationship, the subject deserves a closer look. Here is what every therapist in Switzerland should know before billing a no-show.
Under Swiss law, the therapist-patient relationship falls under the mandate contract (Art. 394 ff. of the Code of Obligations). The therapist commits to providing a service, and the patient to honouring their commitments — including showing up for agreed appointments.
When a patient fails to show up without cancelling within the agreed timeframe, they cause damage to the therapist (lost income, non-reusable slot). Swiss law allows the therapist to seek compensation, provided the rules were clearly communicated beforehand.
Key point: there is no specific law prohibiting or authorising the billing of no-shows. It is the contract between you and your patient that prevails. Hence the importance of a written policy.
For therapists billing under Tarif 590 (complementary medicine), position 1250 is designed exactly for this case: the missed consultation. It allows billing for an appointment the patient did not attend, provided a prior agreement exists.
However, this position does not guarantee reimbursement by the patient's supplementary insurance. We will come back to this.
Without a prior written agreement, billing a no-show is legally fragile. A patient can dispute the invoice by claiming they were not aware of the conditions. To protect yourself, include a cancellation clause in your therapeutic contract from the very first session.
Any appointment not cancelled within 24 working hours will be billed at 100% of the session rate. In case of late cancellation (less than 24 hours), an amount corresponding to 50% of the rate may be billed. This policy applies from the date of signing this contract.
The most common practice in Switzerland is a 24-hour deadline. Some therapists opt for 48 hours, particularly when sessions are long or appointment demand is high. Both are legally defensible — the key is that the deadline is clearly stated and accepted by the patient.
Two approaches coexist:
Some therapists apply a fixed rate (e.g. CHF 80.–) rather than a percentage. This is entirely possible, as long as the amount is communicated in advance.
Don't rely on a notice in the waiting room. For the clause to be enforceable:
The more transparent the communication, the fewer disputes you will have.
If you work under Tarif 590, you use tariff position 1250 to bill a missed consultation. The invoice is formatted like any 590 invoice, with the mandatory DataMatrix and your RCC number.
The number of billed periods corresponds to the planned session duration. If the patient had booked a 60-minute slot (12 periods), you bill 12 periods at the agreed rate.
For therapists not working under Tarif 590, or when position 1250 is not applicable, billing is done via a standard private invoice. Clearly indicate:
Important: the vast majority of supplementary insurance companies refuse to reimburse missed consultations. Position 1250 exists in the tariff, but insurers consider that no therapeutic service was provided. The patient will pay out of pocket.
A patient hospitalised in an emergency or involved in an accident obviously cannot cancel in time. In this case, billing would be disproportionate. Most therapists waive the fee upon presentation of a justification (medical certificate, hospital attestation).
Some therapists choose not to bill the first no-show, treating it as a warning. This is a pragmatic approach: it preserves the relationship while opening the discussion about the rules.
When the patient is a minor, the responsibility for cancellation lies with the parents or legal representative. The no-show invoice is therefore addressed to the parents. Specify this in your therapeutic contract to avoid any ambiguity.
The best no-show invoice is the one you never have to send. Here are the strategies that work:
A practice management software adapted for Swiss therapists, like Therago, integrates automatic reminders and appointment tracking to reduce no-shows without extra effort.
Yes. The mandate contract can be terminated by either party (Art. 404 CO). If a patient repeatedly fails to respect the agreed conditions, you are entitled to end the treatment, with reasonable notice and by suggesting a referral to a colleague.
No. Therapeutic services are VAT-exempt under Art. 21 para. 2 no. 3 LTVA, and this exemption extends to the billing of missed consultations.
You have the same remedies as for any unpaid invoice: reminder, formal notice, then potentially debt collection (LP). In practice, for amounts of CHF 80 to 150, a written reminder is sufficient in the vast majority of cases.
Yes, the principle is identical. A booked video session that is not attended represents the same lost income as an in-person session. The cancellation conditions must be the same regardless of format.
Billing a no-show in Switzerland is legal and legitimate, provided you have a clear framework. The essentials boil down to three points:
Managing no-shows is part of the reality of independent practice. By handling it professionally and transparently, you protect your practice while maintaining a relationship of trust with your patients.
Starting your practice? Check out our complete guide on how to open a therapy practice in Switzerland. To understand consent obligations, read our article on consent forms and legal obligations. And to master Tarif 590 billing, discover our complete Tarif 590 guide for 2026.
Reduce no-shows with automatic reminders? Therago handles it for you.
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