Psychological psychotherapy

Submitting a bill with a provisional tariff

If the canton has set a provisional tariff, you can bill your services to us directly on this basis (tiers payant). Please note the following:

Medical prescription

Send the client’s medical prescription to us along with the first bill:

CSS
Postfach 2550
6002 Luzern

Email address: fax.scan.center@css.ch

Good to know

For each medical prescription, we assume the costs under basic insurance of no more than

• 15 assessment and therapy sessions or
• 10 sessions of crisis intervention or short-term therapy for patients newly diagnosed with a serious medical condition or facing a life-threatening situation.
  

After that, the prescribing doctor and the psychotherapy professional must exchange information before another prescription can be issued.

For the medical prescription, we need the fully completed 'Prescription for psychological psychotherapy' form.

Case assessment after session 30

If the psychotherapy should be continued after 30 sessions, you must submit a further 'Application for case assessment' form.

CSS
Medical Advisory Service
Postfach 2568
6002 Luzern

Email address: avd.d@css.ch

Your billing information (OKP)

We require the following information from you so that we can check and pay your bills for services under basic insurance (OKP):

• Client's personal details and insurance data (surname, first name, home address, gender, date of birth, insurance and social insurance number)
• Service provider's paying agent register no.
• Responsible psychotherapist's GLN
• Treating psychotherapist's GLN
• Prescribing doctor's paying agent register no. and GLN
• Treatment (from/to)
• Type of treatment (outpatient/inpatient)
• Reason for treatment (illness/accident/pregnancy/prevention/congenital anomaly)
• Diagnosis code in accordance with ICD10, at the level of detail permitted by law
• Billing number and date
• Tariff, item number, item text, number, tariff points, tariff point value, amount and date of the service in question
• Total amount being billed
• Payment information (QR code standard)

Send the bill to:

CSS
Postfach 2550
6002 Luzern

Email address: fax.scan.center@css.ch

We will be happy to receive your bills electronically using the current XML standard of organisation for exchanging data.

Waiting period

CSS generally checks and pays bills within 30 days. This can take longer if specific questions need to be clarified.

Reimbursing persons in training

'In training' comprises:

• Persons who are completing an accredited psychotherapy training course;
•  ‘Federally approved’ [Eidg. anerkannt] psychotherapists who are in the process of completing their third clinical year in accordance with Art. 50c para. b KVV;
• Persons who have completed their postgraduate training but have yet to complete their year of training accredited by the Swiss Institute of Medical Education (SIWF/ISFM) in accordance with Art. 50c para. b KVV. These persons may draw on the 'in training' status for two years.
  

The following rules apply to all these persons:

• Their services are reimbursed subject to a proviso of which the patients must be informed.
• The service must be provided under the close supervision of a professional to ensure its quality and effectiveness. If a therapist recognised under mandatory healthcare insurance is present at the session, the service can only be billed once. Both therapists cannot issue a bill. The bill must clearly show the name of the person receiving the therapy.
• Services provided by persons in training are to be billed at the tariffs provisionally set by the cantons, with a discount of 10%.

Psychotherapy services billed under supplementary insurance (VVG)

Psychological psychotherapists recognised by CSS can continue to bill the cost of psychotherapy services under supplementary insurance if the clients in question have relevant cover.

Due to tariff protection, it is not possible to reimburse psychotherapy services under a mix of both basic and supplementary insurance. Services provided by psychotherapists recognised by CSS who now provide therapeutic services under mandatory healthcare insurance (OKP) will no longer be reimbursed under supplementary insurance.

Important information

From 1 March 2025 a paying agent register number (ZSR no.) for psychotherapy under the VVG is an essential requirement. You can request this ZSR number directly from SASIS AG. Details of how to do this can be found along with the application on the page SASIS.

As a general rule: Recognition by CSS under supplementary insurance is only possible if you are not already authorised to bill your services under the OKP in any canton.

Your billing information (VVG)

We require the following information from you so that we can check and pay your bills for services under supplementary insurance (VVG):

• Client's personal details and insurance data (surname, first name, home address, gender, date of birth, insurance and social insurance number)
• Service provider's personal details
• Treatment (from/to)
• Reason for treatment (illness/accident/pregnancy/prevention/congenital anomaly)
• Billing number and date
• Title, amount and date of the service in question
• Total amount being billed

Submitting bills

Please always send your bills directly to the client. The insured person can then check the bill and send it to CSS for reimbursement (tiers garant system).

Contact

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