By Anne T. T. · Published April 12, 2026 · 9 min read
Tarif 581 governs the billing of psychotherapy covered by mandatory health insurance (LAMal) since July 1, 2022. This date marked a major turning point for psychologist-psychotherapists in Switzerland: the end of the delegation model and direct access to LAMal billing via the prescription model (Anordnungsmodell), anchored in Art. 11b OAMal (RS 832.102).
In concrete terms, the cost of psychotherapy covered by LAMal rose from CHF 528 million to CHF 922 million between 2021 and 2024. This figure reflects both broader access to care and increasing pressure on practitioners to bill correctly. Mastering Tarif 581 is no longer optional — it is a core practice management skill.
This guide covers the prescription model by 15-session blocks, the distinction between Tarif 581 and 582, provisional cantonal rates, tariff codes and pitfalls to avoid.
The prescription model is based on a simple principle: a doctor prescribes, the psychologist treats and bills. But the renewal rules follow a tiered logic that you need to know inside out.
The patient sees a prescribing doctor — family doctor, psychiatrist, paediatrician, or any doctor holding a recognised specialist title (Art. 11b para. 1 OAMal). This doctor assesses the psychotherapeutic need and issues a prescription for a first block of 15 sessions maximum.
If treatment needs to continue beyond the first 15 sessions, the prescribing doctor can extend the prescription for a second block of 15 sessions. This renewal does not require the insurer's approval — a new prescription from the doctor is sufficient.
The psychologist must, however, inform the prescribing doctor of the treatment progress. This feedback has no imposed format, but a brief follow-up report (objectives, progress, outlook) is recommended.
From the 31st session, the rules change. The psychologist must submit an extension request to the medical advisor (Vertrauensarzt) of the patient's insurance. This request contains:
Note: in practice, refusals remain rare when the clinical documentation is solid, but response times vary significantly between insurers.
For patients under 18, the prescription model applies in the same way, but the prescription can be issued by a paediatrician in addition to GPs and psychiatrists. The 15-session blocks and the 30-session threshold remain identical. The main difference concerns tariff codes: some codes provide for adapted durations for sessions with children (including coordination time with parents or school).
The confusion between Tarifs 581 and 582 is common. Both share the same code families (PA, PB, PE, PK, PL, PN, PW), but apply to different insurance regimes.
| Criterion | Tarif 581 | Tarif 582 |
|---|---|---|
| Domain | LAMal — mandatory health insurance | LAA / LAI / LAM — accident, disability, military |
| Legal basis | Art. 11b OAMal (RS 832.102) | CTM tariff convention |
| Model | Medical prescription (Anordnungsmodell) | Tariff convention with insurers |
| Provisional rate | CHF 2.58/min (set by Federal Council) | Point system (Pt PM x VPt PM) |
| Typical case | Private practice patient, GP prescription | Accident victim, AI or AM insured |
In practice, the vast majority of your patients fall under Tarif 581 (LAMal). You enter "581" in the tariff field of the invoice. Tarif 582 only concerns accident, disability or military insurance cases — see our dedicated Tarif 582 guide for specifics.
Tarif 581 operates on a provisional per-minute rate set by the Federal Council at CHF 2.58/min, or approximately CHF 154.80 per hour of session. This rate is called "provisional" because negotiations between the FSP (Swiss Federation of Psychologists) and insurers for a definitive rate have not yet concluded. The target is a definitive rate by January 1, 2027.
| Canton | Cantonal factor | Effective rate/hour (approx.) |
|---|---|---|
| Geneva (GE) | 1.08 | ~CHF 167.20 |
| Vaud (VD) | 0.97 | ~CHF 150.15 |
| Zurich (ZH) | 1.00 | ~CHF 154.80 |
| Valais (VS) | 0.93 | ~CHF 143.95 |
| Bern (BE) | 0.96 | ~CHF 148.60 |
Psychologists in postgraduate training (not yet holders of the federal title) can bill under the supervision of a recognised psychologist-psychotherapist, but with an external factor of 0.9 applied to the rate. In practice, the per-minute rate drops from CHF 2.58 to CHF 2.32, or approximately CHF 139.30 per hour.
Tarif 581 comprises 7 code families, each covering a type of service. Here are the most commonly used ones.
PA — Psychological diagnosis (patient present)
PA codes cover diagnostic sessions with the patient present: anamnesis, clinical assessment, test administration.
PB — Psychotherapeutic treatment (patient present)
The PB family is the core of billing. It covers psychotherapy sessions proper.
PB010 is the code you will use most frequently. Each session is billed at the actual minute (not as a flat-rate session).
PE — Patient absent
PE codes cover work performed without the patient present: report writing, coordination, session preparation.
Tip: this code is often underused. The time spent writing reports for the prescribing doctor or medical advisor is billable — do not leave it out.
PK — Coordination
PK codes cover exchanges with other healthcare professionals involved in the patient's care.
PL — Reports
PL codes cover the drafting of formal reports, particularly those required by insurance beyond 30 sessions.
PN — Emergencies
PN codes cover services in emergency situations, with possible supplements for consultations outside business hours.
PW — Special services
PW codes cover services that do not fit into other categories — travel, expert assessments, etc.
1. Systematically verify the prescription
2. Count your sessions rigorously
Practice management software that automates this tracking will spare you reimbursement refusals.
3. Prepare your reports in advance
The report for the medical advisor (30-session threshold) takes time. Do not write it the day before — start preparing it from the 25th session. Include:
4. Bill the invisible work
Time spent outside sessions (PE010), coordination (PK010) and reports (PL010) are billable. Many practitioners only bill in-person sessions (PB010) and thus lose legitimate revenue. Document every activity with the actual duration.
5. Keep your numbers up to date
A missing or incorrect number triggers automatic rejection by the insurance.
Can the patient choose their psychologist-psychotherapist?
Yes. The prescribing doctor issues the prescription, but the patient is free to choose their psychologist-psychotherapist, provided they are recognised (federal title, RCC number, cantonal registration). The doctor may recommend a practitioner but cannot impose a choice.
What if the prescription expires or the patient changes doctor?
The law does not set an explicit validity period for the prescription. However, if the prescribing doctor changes, the new doctor can issue a new prescription. The session counter does not reset to zero — sessions already completed under the previous prescription count towards the total of 30.
Does the prescription have to be issued by a psychiatrist?
No. Any doctor holding a federal specialist title can prescribe psychotherapy: family doctor, paediatrician, gynaecologist, etc. The psychiatrist does not have a monopoly on prescriptions. This is a major change from the former delegation model.
What happens if the medical advisor refuses the extension beyond 30 sessions?
Treatment can no longer be billed to LAMal beyond the 30th session. The patient can: appeal the decision with their insurer, continue treatment at their own expense, or obtain a new prescription if their clinical situation evolves. In practice, a detailed and well-documented report greatly reduces the risk of refusal.
Which tariff applies — 581 or 590?
Tarif 590 concerns psychologists' services that do not fall under the prescription model (for example, services outside LAMal, or non-psychotherapist psychologists). If your patient has a medical prescription and you are a recognised psychologist-psychotherapist, Tarif 581 applies. For a full comparison, see our 590 vs 581 vs 312 comparison article.
Tarif 581 has opened direct, autonomous access to LAMal billing for psychologist-psychotherapists. But this autonomy comes with real administrative responsibility: managing prescriptions, tracking session thresholds, clinical documentation, tariff codes.
Practice management software that automates session counting, alerts on thresholds (15/30), and generates compliant invoices in tiers garant format saves considerable time — and avoids reimbursement rejections. Therago integrates full Tarif 581 management: automatic session block tracking, renewal alerts, and compliant billing with QR-Bill. See how to simplify your billing.
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