Psychological psychotherapy

Submitting a bill with a provisional tariff

If the canton has set a provisional tariff, bills based on this provisional 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

For each medical prescription, costs will be covered for 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 illness or facing a life-threatening situation.

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

The medical prescription must contain all the information requested in the 'Prescription for psychological psychotherapy' form.

Case assessment after session 30

If the psychotherapy is to be continued after 30 sessions, a further 'Application for case assessment' form can be submitted to us.

CSS
Vertrauensärztlicher Dienst
Postfach 2568
6002 Luzern

Email address: avd.d@css.ch

Billing information (OKP)

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 Datenaustausch 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

'Persons in training' is understood to mean:

• 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 letter 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 letter b KVV. These persons may draw on this status for 2 years.
  

The following rules apply to 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.

Recognition of VVG therapists

Complete the 'Application for VVG recognition' form and send it back to us electronically.

Email address: info.psychotherapeuten@css.ch

Billing information (VVG)

We require the following information to ensure the process of checking and paying bills for services under supplementary insurance (VVG) 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 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
  

Bill to

CSS
Postfach 2550
6002 Luzern

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

Contact

Do you have any questions about psychological psychotherapy?