TARMED / TARDOC (Swiss Outpatient Physician Tariff)

From TARMED to the Overall Tariff System

Outpatient physician services in Switzerland are billed under a nationally uniform tariff structure that the tariff partners – physicians (FMH), hospitals (H+) and insurers (prio.swiss) – negotiate under Art. 43 et seq. KVG and that the Federal Council must approve. The fee-for-service tariff TARMED, introduced in 2004 with more than 4,600 items, was never fully revised and increasingly contained over- and undervalued services. After several attempts, the Federal Council approved the overall tariff system on 30 April 2025, in force since 1 January 2026: TARDOC as a fee-for-service tariff with around 1,400 items, primarily for primary care in simple infrastructures, and around 300 outpatient flat rates for more complex, standardisable procedures such as arthroscopies or cataract operations, which cover all associated services including medicines and implants. Under Art. 43 para. 5bis KVG flat rates take precedence over fee-for-service; combinations are excluded. Further development rests with OAAT AG, founded by the tariff partners; the first update is scheduled for 1 January 2027.

Mechanics and Remuneration

Each tariff item carries tax points reflecting medical and technical effort. The invoice amount is tax points multiplied by the tax point value, which is negotiated cantonally between insurers and providers or, failing agreement, set by the cantonal government. The system change must by law be cost-neutral; OAAT AG monitors costs and volumes for this purpose. On invoices, TARDOC services carry tariff code 007 and flat rates tariff code 005. The UVG Medical Tariff Commission has agreed with FMH and H+ to apply the new system to accident, military and disability insurance as well.

Country Comparison and Practice Note

Germany remunerates statutory outpatient services through the Uniform Value Scale (EBM) with a regional point value and private patients through the GOÄ fee schedule; Austria uses fund-specific fee catalogues. For health and accident insurers the tariff structure is a main driver of outpatient cost trends and thus premiums; supplementary and UVG insurers must align their claims adjudication and cost approval processes with the new tariff codes.