Psychological psychotherapy

Independent psychological psychotherapists can now bill their services under basic insurance (mandatory healthcare insurance, OKP). This gives people with mental health problems easier access to psychotherapy.

Billing the health insurer

Many questions regarding the tariff structure and amount still need to be clarified. So, to ensure that bills can be issued despite this, we have asked the cantons to set a working tariff.

  • We would ask therapists not to issue any bills for services under basic insurance to clients until a tariff has been determined.
  • As long as therapists feature on the CSS list of recognised therapists and clients have the right form of insurance, we can continue to cover the costs under supplementary insurance.

Submitting a bill with fixed tariff

If the canton has set a tariff, bills based on this fixed tariff can be sent to us directly (tiers payant). Please note the following:

Medical prescription

The medical prescription issued to the client must be submitted along with the first bill, at the latest.

CSS
Postfach 2550
6002 Luzern

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

Good to know

The cost of no more than 15 assessment and therapy sessions will be covered under each medical prescription. After that, the prescribing doctor and the psychotherapy professional must exchange information before another prescription for, at most, a further 15 sessions can be issued.

The medical prescription must contain all the information requested in the form.

Case assessment after session 30

If the psychotherapy is to be continued after 30 sessions, a further form can be submitted to us.

CSS
Vertrauensärztlicher Dienst
Postfach 2568
6002 Luzern

Email address: avd.d@css.ch

Billing information

We require the following information to ensure the process of checking and paying bills for services under basic insurance (OKP) runs smoothly:

  • 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)

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 the Forum Exchanging data organisation.

Waiting period

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

Contact

Would you like further information about billing psychological psychotherapy?