The Practical Guide: Payment solutions for psychotherapists and coaches in Switzerland

In terms of payments, psychotherapy practices operate fundamentally differently from physiotherapy or TCM: Psychotherapists covered by mandatory health insurance (KVG) bill via health insurance and generally do not collect payments on site. Self-payers and coaching clients pay the full amount directly – most sensibly via Payment Link after the session, not via a terminal in the consulting room.

This guide explains the different billing models in Swiss psychotherapy, why a terminal in the consulting room disrupts the setting, and which payment solution suits which situation.

1. The three billing models in Swiss psychotherapy

Model A: Health insurance-approved psychotherapy (KVG)

Psychotherapists with KVG approval (medical psychotherapists as well as psychological psychotherapists under the prescription model, i.e. on medical prescription) bill directly via basic health insurance. Patients pay the standard deductible (at least EUR 300/year for adults) and the 10% co-payment. These amounts are billed at the end of the quarter or year via the health insurance fund – not collected directly on site. This means: no payment process in the practice, no terminal required to conclude the session.

Modell B: Non-insurance-approved psychotherapy / Self-payers

Psychotherapists without KVG approval – or treatments without a medical prescription – offer their services privately. Patients pay the full session fee themselves: typically EUR 130 to EUR 250 per 50-minute session. Some supplementary insurance policies cover a portion. This share must be collected directly.

Model C: Coaching and counselling

Coaches, life counsellors, and mental trainers are not subject to KVG and fundamentally collect all payments directly. Session rates are typically EUR 150 to EUR 350 per hour, and package offers (e.g. 5-session coaching package) range from EUR 800 to EUR 2,000. In this segment, advance payment upon booking is particularly common – both via Payment Link and via Payrexx Pages.

2. Why a terminal in the consulting room harms the therapeutic setting

In psychotherapy, the end of a session is a sensitive moment. The conversation concludes, often after intense topics, and the therapist accompanies the client to the exit. Presenting a terminal, waiting for card payment, printing a receipt – this disrupts the transition and feels clinical. Many psychotherapists describe this as detrimental to the therapeutic relationship.

Payment Links resolve this issue structurally: After the session, the therapist sends a link via SMS. The client pays at home or on the go, whenever they wish. This completely decouples payment from the therapeutic setting. For online sessions (Zoom, Teams), a Payment Link is the only sensible solution anyway.

Another aspect: In group therapy or institutional settings, paying at a terminal can feel socially awkward when other participants are watching. Payment Links enable discreet individual billing, independent of the group setting.

3. Payment Link: The payment workflow for psychotherapy practices

The process is remarkably simple: hold the session, conclude the session, leave the practice. Afterwards – either on the same day or the following morning – create a Payment Link in the Payrexx Dashboard and send it via SMS or WhatsApp. The client clicks the link, selects TWINT, card, or mobile wallet, and pays. The payment appears immediately in the Dashboard.

Payment Links are available in all Payrexx plans, including Free. For practices that exclusively use Payment Links (no terminal, no Tap to Pay), the Free plan provides a complete setup with zero fixed costs. Transaction fees via the Standard plan: TWINT 1.25% + EUR 0.18, Visa/Mastercard 1.65% + EUR 0.18 (as of: October 2026).

For coaching packages: Payrexx Pages

Those selling coaching packages (e.g. 5-session package, 3-month programme) can create a Payrexx Page once with the package options and share the URL on their website or in the booking confirmation. Clients book and pay in a single step. This works without a booking tool plugin and across all plans.

4. Billing online sessions: Zoom, Teams, and more

Remote psychotherapy and online coaching have become permanently established in Switzerland since 2020. For these sessions, the Payment Link is the only practical payment solution. No terminal, no on-site QR code – the link is sent via email after the session. Or even more elegantly: in advance, so that the client has already paid before the session begins.

For regular weekly or bi-weekly online sessions, recurring payments via credit card are recommended: The client enters credit card details once, and the amount is debited automatically after each session. Recurring payments are available across all Payrexx plans. TWINT does not support recurring payments – Visa or Mastercard is required for this.

5. Managing insurance patients and self-payers simultaneously: Keeping accounting neat and separate

Many psychotherapists run a mixed practice: Some patients are covered by basic insurance, while others pay directly. In the Payrexx Dashboard, all direct payments can be assigned a booking text and exported as a CSV. Recommended convention: 'Self-payer [Initials/ID]' vs. 'Coaching [Client name]' – this maintains categorisation without exposing patient data in the payment solution.

Data privacy notice: No diagnoses or detailed patient data should be entered as booking text in the Payrexx Dashboard. Under data protection law, payment data and patient data must be kept strictly separate. The booking text serves internal allocation only – initials or a patient ID are sufficient.

6. Cost comparison: What pays off for a psychotherapy practice?

With 20 sessions/month at EUR 160 via TWINT: Free = EUR 47.60 in fees, Standard = EUR 43.60 + EUR 19 subscription = EUR 62.60 total. For small practices with few direct payments, the Free plan is often more cost-effective than Standard. From approximately 40 direct sessions/month, Standard becomes worthwhile. As of: October 2026.

7. Checklist: Setting up a payment solution for your psychotherapy practice

• Clarify which billing model you use: KVG insurance-approved, self-payer, or coaching

• Set up a Payrexx account – the Free plan is sufficient for Payment Links and recurring payments

• Create a Payment Link template for your standard session price (under 1 minute in the Dashboard)

• Enable TWINT and credit card as payment methods

• For coaching packages: Set up a Payrexx Page with package options and a fixed URL

• For weekly online sessions: Set up recurring payments with credit card

• Define booking text conventions: initials or patient ID, no diagnoses

• Review privacy policy for payment processing (FADP Art. 9, DPA with Payrexx)

Payrexx offers psychotherapists and coaches Payment Links, recurring payments, Payrexx Pages, and Invoice from a single account – with TWINT, credit card, and mobile wallets without separate contracts. The Free plan with no monthly fee provides a complete setup for solo practices that primarily use Payment Links.