Physiotherapists in Switzerland are allowed to charge no-show fees – but only if the fee has been communicated transparently in advance, is proportionate, and an actual loss of earnings has occurred. The technically simplest safeguard is pre-authorisation via credit card during online booking, combined with a clear no-show policy in the T&Cs.

This guide explains the Swiss legal situation (CO Art. 160 et seq.), shows you how to determine a proportionate fee, and how to technically implement pre-authorisation via Payrexx.

1. The problem: Unexcused missed appointments cost real money

A 50-minute physiotherapy appointment that is missed without excuse means a complete loss of performance for the practice without compensation. With a self-payer session price of EUR 120 and ten no-shows per month, this results in a EUR 1'200 loss of revenue monthly. On top of that comes the effort: filling gaps at short notice, following up, and in the worst-case scenario, unpaid reminders for patients who did not show up.

The problem is structural: Anyone who can cancel an appointment free of charge – or simply not show up – has no financial incentive to stick to appointments. A clear no-show policy with financial consequences is proven to change behaviour.

2. Legal situation: What the Code of Obligations allows

In Switzerland, booking an appointment constitutes a contract – even without written confirmation. If one party does not comply with the contract, the other side can generally claim damages (CO Art. 97 et seq.). In practice, however, this is difficult to enforce: The practice must prove that the appointment slot could not be filled otherwise and that an actual loss of income has occurred.

The more elegant solution is the contractual penalty pursuant to CO Art. 160 et seq.: In this case, a fixed fee is agreed contractually in advance, which becomes due in the event of non-performance – without proof of damage. This requires a clear agreement that is accepted at the time of booking – e.g. T&C agreement in the booking confirmation.

3. What the SPO says about no-show fees

The Swiss Patient Organisation (SPO) considers no-show fees to be generally permissible, but states clear conditions: The fee must have been communicated during booking, must only reflect the actual loss incurred, and must be proportionate. A flat-rate 100% billing of the session price is only justifiable if it can be proven that the slot could not be filled otherwise.

The SPO explicitly recommends goodwill in the event of unpreventable cancellations – accidents, sudden illness. This is not a legal obligation, but a practice that stengthens the relationship of trust with patients in the long run.

4. How high may the fee be?

There is no statutory upper limit. The fee must be proportionate and reflect the actual loss. In practice, the following guide values have become established among Swiss therapy practices:

Important: If the appointment slot is filled by another person at short notice, no loss has occurred and the fee cannot be claimed. Therefore, document no-shows and whether the slot was refilled.

5. Pre-authorisation via Payrexx: Technical implementation

Pre-authorisation is technically the simplest and most effective method for enforcing no-show fees. During online booking, the patient enters their credit card details – no amount is charged immediately. Payrexx reserves the agreed amount on the card. If the person shows up for the appointment, the actual session amount is debited or the reservation is released. If they fail to appear, the no-show fee is debited with a few clicks in the Dashboard.

Payrexx supports pre-authorisation for Visa, Mastercard (debit and credit), Apple Pay, Google Pay, and Samsung Pay. TWINT and PostFinance do not technically support pre-authorisation. For TWINT-paying patients, a prepayment with a refund option in the event of timely cancellation is recommended.

Step-by-step setup

• Set up a Payrexx account (Standard or Premium for full functionality)

• Configure booking page or payment link with pre-authorisation

• Formulate no-show policy in T&Cs: deadline, amount, exceptions

• Integrate T&C agreement into the booking process – before booking completion

• In the event of a no-show: debit the reserved fee in the Payrexx Dashboard

• In the event of timely cancellation within the deadline: release the reservation, no charge

6. Formulating a no-show policy: Sample text

A legally compliant no-show policy needs three elements: the cancellation deadline, the fee amount, and the exception rule. Sample text for T&Cs:

'In the event of cancellations less than 24 hours before the agreed treatment or in the event of unexcused absence, a cancellation fee of EUR [amount] will be charged. In the event of a proven emergency (accident, sudden illness), the fee will be waived. The fee will be debited via the credit card stored during booking or sent via invoice.'

You can choose the cancellation deadline (here 24 hours) freely – there is no statutory deadline in Switzerland. 24 to 48 hours are standard in the industry and are perceived as fair by patients.

7. Checklist: Setting up no-show fees in the physiotherapy practice

• Formulate a no-show policy with cancellation deadline, fee amount, and goodwill rule

• Integrate the policy into the T&Cs and require agreement during booking

• Set up pre-authorisation in the Payrexx Dashboard (Visa, Mastercard, Mobile Wallets)

• For TWINT patients: prepayment with refund option as an alternative

• Document every no-show: Date, whether slot was refilled yes/no, fee charged yes/no

• Define a goodwill rule internally: e.g. first no-show without a fee, starting from the second with a fee

• Communicate the policy proactively: note in appointment confirmation and on the booking page

• Review annually whether the fee amount is still proportionate

Payrexx supports pre-authorisation for all popular credit cards as well as Apple Pay, Google Pay, and Samsung Pay.

You store the credit card details during booking and, in the event of a no-show, debit the agreed fee directly in the Dashboard – without manual invoicing and without collection proceedings. Combined with payment links for standard payment after the session, this covers the entire payment workflow.