Card payment in the physiotherapy and osteopathy practice: How it works in Switzerland

Swiss physiotherapy and osteopathy practices collect franchise shares, deductibles and non-health insurance covered services directly from patients – typically EUR 10 to EUR 150 per session. POS terminal, Tap to Pay on an Android smartphone or Payment Link via WhatsApp are the three practice-proven solutions that differ depending on the practice structure and workflow.

This guide shows you which payment flows actually occur in Swiss physiotherapy and osteopathy practices, which amounts are collected directly and which solution fits your practice.

1. Who pays what – and why outstanding items are a problem

Billing in physiotherapy in Switzerland is divided into three parts: The mandatory health insurance (OKP, also KVG) covers medical prescribed physiotherapy – but not completely. Patients pay an annual franchise (adults at least EUR 300, selectable up to EUR 2'500) as well as a deductible of 10% of the costs after deduction of the franchise. These amounts are not covered by health insurance and must be paid directly at the practice.

For private patients without a medical prescription – for example, for sports massages or preventive treatments – the full session price of typically EUR 90 to EUR 150 is due directly. In osteopathy practices, this share is even higher, as osteopathy is only billed through supplementary insurance. Anyone who does not have supplementary insurance pays the full amount themselves.

The structural problem: Many practices issue paper invoices with a 30-day payment term for deductibles and direct payments. This leads to outstanding items, dunning runs and time expenditure. If payment is collected directly after the session via card, TWINT or Payment Link, this effort is eliminated.

2. Which payment methods Swiss patients expect

TWINT is the most widely used mobile payment method in Switzerland with over 4 million active users and is particularly popular in therapy practices. Debit cards – today Visa Debit and Mastercard Debit, formerly Maestro – are standard. The Maestro card has been gradually replaced by Visa Debit and Mastercard Debit since 2023; these work without problems on any modern terminal.

PostFinance Card is still widespread in German-speaking Switzerland, especially among older patients. According to the payment methods survey of the Swiss National Bank (SNB), the share of cash for payments has fallen below 40%. Credit cards are used less frequently, but are relevant for higher amounts for private patients.

3. POS terminal, Tap to Pay or Payment Link: What fits the physiotherapy practice?

For physiotherapy and osteopathy practices, there are three practical payment solutions from Payrexx that can be combined.

POS terminal at reception

A physical card terminal – at Payrexx the Nexgo N6 or N86 – is suitable for practices with a reception or reception area. Patients pay directly at the reception when leaving. The regular rental price is EUR 25 per month; currently N6 and N86 are available free of charge while supplies last. POS requires at least the Standard plan (EUR 19/month). The terminal accepts cards, TWINT, Apple Pay, Google Pay and Samsung Pay.

Tap to Pay on the Android smartphone

Payrexx Tap to Pay turns a compatible Android smartphone (Android 8.1 or higher, NFC-capable) into a payment terminal – without a separate device. The Payrexx Tap to Pay app is installed on the Android device and connected to the Payrexx account. Patients hold their card, TWINT or wallet to the smartphone. Tap to Pay is available in every Payrexx plan, including the Free plan. Transaction fees are identical to the POS terminal: Debit 0.95% + EUR 0.15, Credit 1.25% + EUR 0.15, TWINT 1.25% + EUR 0.00. Important: Tap to Pay currently only works on Android devices, not on iPhones.

Payment Link after the session

A Payment Link is created directly in the Payrexx Dashboard and sent to the patient via SMS or WhatsApp. The patient pays on their smartphone with their preferred payment method. Ideal if there is no reception, the amount is only determined after the treatment, or the therapist wants to bill directly from the treatment room without a physical payment process. Payment Links work in every plan including Free.

4. Online booking and advance payment: Structurally preventing outstanding items

If you link appointment booking and payment, you solve the dunning problem at its root. Patients book online and either make an advance payment or leave credit card details for a possible no-show fee. For this workflow, Payrexx offers Payment Links and hosted payment pages which you can integrate into booking confirmation emails or booking tools.

For series, advance payment of the deductible share at the beginning is recommended: 10 sessions at EUR 100 KVG rate results in EUR 100 deductible in total – collected as an advance payment via Payment Link, any further payment step is eliminated. For private patients with flat-rate prices (e.g. 5 sessions at EUR 120 = EUR 600), the series advance payment improves liquidity and creates commitment.

5. Costs: What a transaction in a physiotherapy practice actually costs

The transaction fees at Payrexx for POS and Tap to Pay are identical regardless of the chosen plan. Differences exist in the online fees (for Payment Links). To compare with SumUp, the most common competitor for small practices:

Example calculation: EUR 120 session (private patient), Payrexx, Mastercard Debit: 0.95% × 120 = EUR 1.14 + EUR 0.15 fixed = EUR 1.29 fee. Net receipt: EUR 118.71. With 80 such transactions per month: EUR 103.20 fees + EUR 19 subscription (Standard) = EUR 122.20 total costs. Postage and time expenditure for 80 paper invoices significantly exceed this amount.

6. Checklist: Setting up card payment in physiotherapy and osteopathy practices

• Clarify which amounts you collect directly: Franchise share, deductible 10%, private patients, services not covered by health insurance

• Choose the matching solution: POS terminal (reception), Tap to Pay Android (flexible), Payment Link (without device) or a combination

• Order POS terminal only with Standard or Premium plan – Free plan is sufficient for Tap to Pay and Payment Link

• Download the Payrexx Tap to Pay App to an Android device (Android 8.1+, NFC) if no terminal is desired

• Set up TWINT as a second payment method – indispensable for Swiss patients

• Actively inform patients: Note in appointment confirmation and signs in the reception area

• If possible, link appointment booking with payment or credit card guarantee for no-show protection

• Test all payment methods internally before go-live – including TWINT and debit card

Payrexx offers physiotherapy and osteopathy practices POS terminal, Tap to Pay and Payment Link from a single account. You sign one contract and accept TWINT, debit card, credit card and mobile wallets – with a consolidated payout report per week or month.