From 1 January 2026, the billing system for outpatient medical benefits in Switzerland will change. Two new pricing models will be introduced, along with a new, clearer and more standardised invoice format.
The TARDOC model replaces the TARMED model, which has been in place for over 20 years.
This is a fee-for-service model, meaning that each medical procedure is equivalent to a number of pricing points, based on the duration of the treatment and the complexity of the procedure.
Alongside TARDOC, a second model is being introduced: outpatient flat rates.
These rates combine all the benefits provided to a patient during a single day of outpatient treatment (consultation, care, equipment, medication, etc.) into a single overall amount.
This system simplifies the billing process and represents more accurately the reality of certain treatments.
The new rates are intended to make billing more accurate, fair and adapted to modern medicine, thanks to a more regular update of benefits.
The new model better reflects current medical practice, whereas TARMED dated back to the 2000s.
It will be easier to update rates to take into account new medical procedures and changes in practice.
TARDOC covers benefits billed on a fee-for-service basis, while outpatient flat rates cover several benefits provided on the same day of treatment.
From 2026, all medical invoices will be issued in a standardised format at national level. This format now includes a page with QR codes, which is required for the administrative processing of invoices.
Even if the invoice has been sent directly to your insurance company, it is important to check it.
As the insured person, you are the only one who can confirm that the benefits invoiced have actually been provided.
Check the following points in particular:
1
Date of treatment
Do the dates match your appointments?
2
Duration of treatment
Does the time indicated seem to match that of your appointment?
3
Equipment and medication
Does the quantity or size of the items billed seem correct?
4
Benefits provided
Were the procedures indicated actually performed by your doctor?
Outpatient flat rates
If a benefit is billed as a flat rate, no other procedures, medication or equipment should be billed separately on the same day.
No, the benefits and refunds will remain the same depending on your insurance policy. The change mainly concerns the way in which doctors and insurers calculate the price of a consultation or medical procedure.
The aim is not to drive costs upwards, but to make pricing fairer and more representative of the work performed. The Swiss authorities are closely monitoring its impact on healthcare costs.
The point value is set at cantonal level, in agreement with healthcare partners (insurers and medical associations). It may therefore differ from one canton to another.
TARDOC applies to fee-for-service billing (each benefit is billed individually), while outpatient flat rates combine several benefits provided on the same day of treatment into a single overall amount.
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