Psychotherapy: what Swiss health insurance covers

When does basic insurance pay for psychotherapy?

Basic insurance pays for psychotherapy if it serves to diagnose or treat an illness (Art. 25 para. 1 KVG). This means therapy for mental or psychosomatic illnesses, individually or as couples, family or group therapy (Art. 2 para. 2 KLV). It pays for methods whose effectiveness has been scientifically proven (Art. 2 para. 1 KLV), and every insurer must cover the same benefits.

Psychological psychotherapists are not doctors, but since 1 July 2022 they have billed basic insurance independently if they are admitted and there is a doctor's prescription (Art. 11b para. 1 KLV); the former delegated psychotherapy under a doctor's supervision has not existed since 1 January 2023.

Who can prescribe psychological psychotherapy?

Regular prescriptions may be issued by doctors with a federal or recognised foreign postgraduate title in general internal medicine, paediatrics, psychiatry and psychotherapy or child and adolescent psychiatry and psychotherapy, and by doctors with the interdisciplinary specialisation in psychosomatic and psychosocial medicine (Art. 11b para. 1 let. a KLV). General internal medicine also includes the former titles “internal medicine” and “general medicine”.

For crisis intervention or short-term therapy for a newly diagnosed serious illness or in a life-threatening situation, a prescription from any doctor with a postgraduate title is enough; the insurer then pays for at most 10 sessions (Art. 11b para. 1 let. b and para. 4 KLV), once per case of illness according to the Federal Office of Public Health (FOPH). Family doctors with the title “practising doctor” (Praktischer Arzt or Praktische Ärztin) can therefore only prescribe these 10 sessions at most; longer therapy requires a regular prescription.

In the family doctor, HMO or Telmed model, you must also follow that model's rules, for example seeing your family doctor first: the insurer then only has to cover services performed or ordered by the model's providers (Art. 41 para. 4 KVG).

How many sessions does health insurance pay for?

For psychological psychotherapy, basic insurance pays for at most 15 assessment and therapy sessions per doctor's prescription and, with a second prescription, 30 in total; after that, prior approval of costs (Kostengutsprache) is required (Art. 11b paras. 2 and 3 KLV). Crisis intervention sessions count towards these 30, for example 10 crisis intervention sessions and 20 on a regular prescription.

The number prescribed is a ceiling: if fewer sessions are needed, the therapy must be limited to them (Art. 56 para. 1 KVG), and the insurer may also review the case before the 30th session. The process:

1. 1The first prescription covers at most 15 sessions, including the assessment (Art. 11b para. 2 KLV).
2. 2Before the prescribed sessions run out, the therapist reports to the prescribing doctor.
3. 3After an exchange between the two, a second prescription for at most 15 sessions is possible.
4. 4To continue after 30 sessions, the prescribing doctor sends the insurer's medical adviser (Vertrauensarzt) a report with a proposal in good time (Art. 11b para. 3 and Art. 3b KLV). The report may only contain the information needed to assess whether the insurer must pay (Art. 3b para. 2 KLV).
5. 5If a doctor in general internal medicine or paediatrics issued the prescription, a psychiatric case assessment is attached to the report (Art. 11b para. 3bis KLV); according to the FOPH, depending on the patient's vulnerability, this can also be done on the basis of the file.
6. 6The insurer tells you within 15 working days of the medical adviser receiving the report whether and for how long it will continue to pay (Art. 3b para. 4 KLV).

Which therapists does the insurer pay for?

Basic insurance only pays for services by admitted psychological psychotherapists or admitted organisations of psychological psychotherapy (Art. 11b para. 1 KLV). The requirements include a cantonal licence, which in turn requires a federal or recognised foreign postgraduate title in psychotherapy (Art. 50c KVV; Art. 24 PsyG); a psychology degree alone is therefore not enough. In hospital outpatient departments, according to the FOPH, the hospital itself counts as the admitted provider.

The FOPH's register of psychology professions, PsyReg, shows who has recognised postgraduate training and a valid licence to practise. However, admission to basic insurance is granted separately by the canton, and only on application (Art. 36 KVG); so ask before the first appointment whether the sessions will be billed to basic insurance. Anyone who does not want to provide services under the KVG (opting out, Ausstand) must tell you so first; basic insurance then does not pay (Art. 44 para. 2 KVG).

What do you pay yourself?

Psychotherapy is subject to the normal cost sharing, with no special rule (Art. 64 KVG): first the deductible of CHF 300 per calendar year or your optional deductible of up to CHF 2'500, then a 10% co-payment of at most CHF 700 a year. Children have no ordinary deductible (CHF 100 to 600 can be chosen), and their co-payment is at most CHF 350 (Art. 64 para. 4 KVG; Art. 93 and 103 KVV).

The date of treatment is decisive: sessions in January count towards the new year's deductible (Art. 103 para. 3 KVV). From the 13th week of pregnancy until eight weeks after the birth, the insurer charges no cost sharing, including for psychotherapy (Art. 64 para. 7 KVG).

For basic insurance services, admitted therapists may not charge anything above the tariff (tariff protection, Art. 44 para. 1 KVG). According to the FOPH, there was still no tariff agreement approved by the Federal Council in June 2026; since 1 July 2022, most cantons have set a provisional time-based tariff of CHF 154.80 per hour. Unless the insurer and the provider have agreed otherwise, you receive the bill and claim the amount, minus cost sharing, back from the insurer (tiers garant, Art. 42 para. 1 KVG). At your request, providers must disclose medical information only to the insurer's medical adviser (Art. 42 para. 5 KVG).

What does basic insurance not pay for?

Without an illness, basic insurance does not pay for any psychotherapy. In particular, the following are not covered:

• Support with relationship conflicts, everyday problems or social stress without an illness.
• In psychological couples or group therapy, the costs for people who are not ill themselves or have no prescription of their own.
• Psychological psychotherapy without a doctor's prescription.
• Therapy with professionals who are not admitted to basic insurance or who have opted out.

What can supplementary insurance cover?

What supplementary insurance pays is set by the insurer itself; it is not bound by the KVG, and the general terms and conditions (AVB) of the product are decisive. Cover may include, for example, therapy without a doctor's prescription or with therapists who have opted out, or care for problems that do not count as an illness, but not your deductible and co-payment (Art. 64 para. 8 KVG). When you take out a policy, you must answer the health questions truthfully (Art. 4 para. 1 VVG). Whether a supplement is worth it is explained in the guide on supplementary insurance; you can compare basic and supplementary insurance in the easyall calculator.