How the KVG tariff reform is changing physiotherapy

The new KVG tariff structure has been submitted

The previous KVG tariff structure dates back to a time when physiotherapy primarily consisted of classic massages and movement exercises. But the reality is different today: neurological rehabilitation after strokes, complex fall prevention programs for senior citizens, telemedicine aftercare or robot-assisted therapies — all of these modern services have so far been insufficiently billed. As a result, many practices were unable to receive fair compensation for their actual expenses, while other services were overstated. This injustice in the system led to increasing dissatisfaction in the industry and made reform inevitable.

From Lump Sum to Precise Billing: The New System in Detail

The core innovation of the reform is the abolition of the previous flat rates in favour of minute-based billing every 5 minutes. While up to now, a 20-minute treatment was paid in the same way as a 40-minute treatment, in future every minute actually worked will be recorded and billed. For the first time, this enables fair compensation that reflects actual workload.

Specific examples of the new billing practice:

• A classic back treatment (25 minutes) will be billed in future at 5 tariff units of 5 minutes
• A complex neurological rehabilitation (60 minutes) includes 12 tariff units — so far, this would also only have been billed as one unit
• Preparation times, follow-up or telemonitoring are recognized as independent services for the first time

Although this change requires precise time recording and complete documentation, it also creates incentives for high-quality, time-consuming therapies. Specialized practices in particular, which previously suffered from the lump sum payment, can now adequately bill for their actual services.

More Responsibility, More Opportunities: The Role of Physiotherapists

The new tariff structure is accompanied by a fundamental shift in responsibilities. Until now, the duration and scope of treatment have often been determined by doctors or payers. In future, physiotherapists will decide independently on the necessary scope of treatment — but will have to justify and document these decisions on a medically sound basis.

This greater autonomy has several advantages:

1. Individual treatment plans: Treatments can be better tailored to patients' needs
2. More flexible treatment durations: The therapy can last exactly as long as medically necessary
3. More professionalization: Physiotherapists are recognized as equal partners in the healthcare system

At the same time, documentation requirements are increasing. Each treatment must not only be recorded in time, but must also be justified in terms of its necessity. This requires:

• Closer coordination with referring doctors
• Precise medical reasons for prolonged or special treatments
• Regular training to meet the new requirements

Economic impact: Who benefits, who must adapt?

Although the reform is legally designed for cost neutrality — which means there is no more money flowing into the system — there will be clear winners and losers. The change is leading to a redistribution of funds within the physiotherapy sector:

Profiting practices:

• Specialized providers of time-consuming therapies (e.g. neurology, geriatrics)
• Practices with modern infrastructure (e.g. robotics, special training equipment)
• Providers of prevention courses (e.g. fall prevention for seniors)
• Therapy Centers with Interdisciplinary Teams

Challenged practices:

• Providers of Standard Treatments with Short Treatment Times
• Practices with Outdated Software That Does Not Support the New Time Recording
• One-person practices with limited administrative staff

The decisive factor for economic success will be the so-called tax point value — i.e. the price that is paid per 5-minute unit. This requires further negotiations between the collective bargaining partners and politicians to ensure the economic viability of the reform.

Practical Implementation: What Practices Should Do Now

The full details of the new tariff structure are expected to be published in mid-June 2026. But practices can and should already be preparing for the changes:

1. Software check and update:

• Check whether the existing practice software supports the 5-minute cycle
• If necessary, switch to modern solutions such as XatlaMed, which already meet the new requirements
• Plan Training for the Team on New Time Recording and Documentation

2. Process adjustments:

• Adapt internal processes for up-to-the-minute recording
• Create documentation templates for the medical justification of treatment durations
• Revise Communication Processes with Referrers and Payers

3. Use continuing education:

• Attend the tariff courses and training courses offered by Physioswiss from mid-June 2026
• Familiarise yourself with the new tariff positions, in particular with the services not shown so far
• Work through case studies to practice the practical application

4. Inform patients:

• Explain transparently about the new billing modalities
• Communicate the benefits of more personalized treatment options
• Point out possible changes in treatment duration

Long-term prospects: A reform with a model character

The new KVG tariff structure is more than just a technical adjustment — it marks a paradigm shift in Swiss physiotherapy. For the first time, actual workload is fairly remunerated and therapists are given more freedom of design. This creates incentives for:

• Higher quality of treatment through appropriate compensation for time-consuming therapies
• Innovation in treatment design, as new services can be better represented
• More attractive working conditions that make the job more interesting for young professionals

At the same time, the reform provides important impetus for the entire healthcare system:

• The greater emphasis on prevention (e.g. through new tariff positions for fall prevention) can save costs in the long term
• Billing by the minute creates more transparency and reduces misuse
• The greater autonomy of physiotherapists strengthens interdisciplinary cooperation

The Collective Bargaining Partners have announced that they will continuously develop the new structure. A tariff structure commission, consisting of equal numbers, should regularly check whether adjustments are necessary. Practices have the opportunity to provide feedback via their associations and thus help shape further development.

Conclusion: A reform that makes physiotherapy fit for the future

The KVG tariff reform 2027 is a historic step for Swiss physiotherapy. It is finally creating a billing system that does justice to the real realities of modern forms of therapy. It is true that the changeover initially requires more documentation and requires investments in software and training. But the opportunities clearly outweigh them: Fairer remuneration, more freedom of treatment and a stronger position of physiotherapists in the healthcare system.

For practices that prepare at an early stage, the reform offers the opportunity to better remunerate their services and differentiate their treatment offerings. Patients benefit from more individualized treatment options that are more tailored to their needs. And the healthcare system as a whole is gaining through greater transparency and efficiency.

The reform is therefore not just a technical adjustment, but an important step towards modernizing physiotherapy in Switzerland — with appeal far beyond the sector.

Further information and support:

• Physioswiss: Official Information on Tariff Reform
• Federal Office of Public Health: Physiotherapy Services

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