Assurance pour les médecins
Tardoc replaces Tarmed: what the self-employed doctor must do
Tardoc and outpatient flat rates replace Tarmed. Here is the effect on your invoice, your income and the preparation of your practice.
Table of contents
- A 20-minute consultation, before and after
- Tariff structure: from the Tarmed point to Tardoc logic
- On the invoice: combinations, deleted items, a worked example
- Tardoc or outpatient flat rate: who switches where
- Cost neutrality: what the law provides, what it changes for your
- Deadlines and preparing the practice
- Compliance checklist
- Frequently Asked Questions
A 20-minute consultation, before and after
Take a 20-minute general practice consultation. Today, you bill it on a fee-for-service basis using the basic Tarmed consultation item, then add extra time if the consultation runs over. Each item carries tariff points, which you multiply by the tariff point value of your canton.
Under Tardoc, the logic remains that of fee-for-service billing. But the structure is rewritten: services are redescribed, their durations are recalculated, and the rules on combining items and on limitations change. The result on your invoice therefore depends on what you usually combine, not just on the basic tariff.
A clarification to avoid a false shortcut. Tardoc is not simply "Tarmed 2.0". It is a new fee-for-service tariff structure, which coexists with outpatient flat rates for another part of the services. Together, the two make up the reform.
A date to remember: the Federal Council approved the tariff structure for entry into force on 1 January 2026. As at 27 October 2026, the switchover is therefore already behind most practices. If you have not yet checked everything (items, software, combinations), the challenge is to catch up, without waiting any longer. Check the detailed arrangements on the websites of the FOPH (OFSP) and the OAAT, as some may still change.
Tariff structure: from the Tarmed point to Tardoc logic
The calculation principle you know does not disappear: a service receives a number of tariff points, multiplied by the tariff point value. This value is set by canton, between the service providers and the insurers. It therefore varies from one canton to another, and an agreement may change it. Check the value applicable to your practice with your cantonal medical society or the agreement in force.
What changes is the content of the items. Tardoc revises the description of services, the reference times, the rules on combining items and the limitations on quantity or duration. Some Tarmed items disappear, others are rewritten or grouped together.
For the established doctor, the consequence is concrete. A billing habit that went through without difficulty under Tarmed may be rejected under Tardoc if a combination rule excludes it. Conversely, a service that was poorly valued before may be better described.
The legal basis is found in the LAMal (Art. 43) and in the ordinance on the setting and adjustment of tariff structures in health insurance. It provides for a single tariff structure at national level, managed by the OAAT tariff organisation. Texts available at fedlex.admin.ch.
On the invoice: combinations, deleted items, a worked example
Three points move a practice's invoice: prohibited combinations, deleted or rewritten items, and recalculated durations.
As for combinations, reread your ten most frequent invoices. Identify the items you almost always associate (consultation, extra time, technical services, report). Each association must be tested in the new structure. An association that has become impossible results in a rejection by the insurer, and therefore in secretarial work and a payment delay.
For the worked example, here is the mechanism, to be filled in with your own data. A 20-minute consultation under Tarmed is calculated as follows: the sum of the tariff points of the items selected, multiplied by the point value of your canton. If the total comes to 60 tariff points and your point value is CHF 0.90, the invoice is CHF 54.00. Under Tardoc, you redo the same calculation with the new items and their tariff points. I am not giving a precise Tardoc amount here: the exact tariff points must be taken from the official tariff published by the OAAT, and the point value remains cantonal. The figures above illustrate the method, not a tariff.
Run this test on a sample of 30 to 50 real consultations. You will quickly see which lines weigh on your turnover.
| Step | Timeframe | Detail |
|---|---|---|
| 1. Reread your most frequent invoices | 10 invoices | Take your 10 most frequent invoices and identify the items that are always associated: consultation, extra time, technical services, report. (Doctor) |
| 2. Test each combination in the new structure | Each association identified | Check that each combination remains possible under Tardoc. A combination that has become impossible results in a rejection by the insurer, secretarial work and a payment delay. (Doctor) |
| 3. Recalculate on real consultations | 30 to 50 consultations | Redo the calculation on a sample of real consultations, using the official tariff points published by the OAAT and the point value of your canton. (Doctor) |
| 4. Assign your procedures to Tardoc or to a flat rate | 20 procedures | Draw up the list of your 20 most frequent procedures and assign each to Tardoc or to an outpatient flat rate, citing the official item. Do not classify from memory. (Doctor) |
1. Reread your most frequent invoices
Timeframe10 invoices
DetailTake your 10 most frequent invoices and identify the items that are always associated: consultation, extra time, technical services, report. (Doctor)
2. Test each combination in the new structure
TimeframeEach association identified
DetailCheck that each combination remains possible under Tardoc. A combination that has become impossible results in a rejection by the insurer, secretarial work and a payment delay. (Doctor)
3. Recalculate on real consultations
Timeframe30 to 50 consultations
DetailRedo the calculation on a sample of real consultations, using the official tariff points published by the OAAT and the point value of your canton. (Doctor)
4. Assign your procedures to Tardoc or to a flat rate
Timeframe20 procedures
DetailDraw up the list of your 20 most frequent procedures and assign each to Tardoc or to an outpatient flat rate, citing the official item. Do not classify from memory. (Doctor)
Key takeaway
Four checks on your own invoices, carried out with the official OAAT tariff points, reveal what Tardoc really changes for your practice.
Source: LAMal (Art. 43) and ordinance on the setting and adjustment of tariff structures in health insurance — fedlex.admin.ch; tariff points and list of flat rates: OAAT, FOPH (OFSP)
Tardoc or outpatient flat rate: who switches where
The reform has two halves. The first, Tardoc, remains fee-for-service billing. The second, outpatient flat rates, groups services into a fixed amount per case. An intervention or treatment that falls under a flat rate is no longer billed item by item.
For a general practitioner, most of the routine activity remains fee-for-service under Tardoc. For a specialist who performs outpatient interventions or repetitive technical procedures, part of the activity may switch to a flat rate. The exact scope depends on the list of approved flat rates. Consult it on the OAAT and FOPH (OFSP) websites before assuming that a procedure remains fee-for-service.
In a group practice, the question becomes more complicated: several doctors bill different services under the same structure. Check that each practitioner has properly identified what falls under Tardoc and what falls under a flat rate, including for procedures performed by delegation of competences to non-medical staff.
A point of method: do not classify your services from memory. Draw up the list of your 20 most frequent procedures and assign each to Tardoc or to a flat rate, citing the official item.
| Criterion | Tardoc | Outpatient flat rates |
|---|---|---|
| Billing method | Fee-for-service, item by item: tariff points × cantonal point value | Fixed amount per case, without item-by-item billing |
| Services concerned | Routine general practice activity | Outpatient interventions and repetitive technical procedures |
| Profile affected | General practitioner: most of the activity remains fee-for-service | Specialist: part of the activity may switch to a flat rate |
| Verification source | Official tariff published by the OAAT (items, tariff points, combination rules) | List of approved flat rates on the OAAT and FOPH (OFSP) websites |
Billing method
TardocFee-for-service, item by item: tariff points × cantonal point value
Outpatient flat ratesFixed amount per case, without item-by-item billing
Services concerned
TardocRoutine general practice activity
Outpatient flat ratesOutpatient interventions and repetitive technical procedures
Profile affected
TardocGeneral practitioner: most of the activity remains fee-for-service
Outpatient flat ratesSpecialist: part of the activity may switch to a flat rate
Verification source
TardocOfficial tariff published by the OAAT (items, tariff points, combination rules)
Outpatient flat ratesList of approved flat rates on the OAAT and FOPH (OFSP) websites
Key takeaway
The general practitioner remains for the most part fee-for-service under Tardoc, whereas the specialist must check which interventions switch to a flat rate.
Source: Art. 43 LAMal and ordinance on the setting and adjustment of tariff structures in health insurance — fedlex.admin.ch; OAAT; FOPH (OFSP)
Cost neutrality: what the law provides, what it changes for your
The Federal Council has set a requirement: the tariff revision must be cost-neutral. In concrete terms, the new structure must not increase the total volume of expenditure of compulsory health insurance compared with the old one. This rule derives from the LAMal and from the ordinance on the tariff structure, and it is the OAAT that ensures its implementation with the tariff partners.
The partners are the service providers (including the FMH), the insurers and, for the flat-rate part, hospital stakeholders. The FOPH (OFSP) monitors compliance and approves the structure.
What neutrality means for your practice: it applies to the system as a whole, not to each practice. Your individual income may rise or fall depending on your activity profile. A practice that works mainly with long consultations will not have the same result as a highly technical practice. Neutrality is an overall balance, not an individual guarantee.
The monitoring and adjustment mechanisms may evolve. Keep this reservation in mind and refer to the publications of the FOPH (OFSP) and the FMH for any corrections. Also think about your loss-of-earnings insurance: if your income varies, check that the insured income remains consistent with your actual situation. On the protection of income and capital, our article on how much life insurance a doctor needs in Switzerland provides a useful framework.
Deadlines and preparing the practice
Five workstreams, to be handled in this order.
Billing software. Check with your vendor that the installed version incorporates the Tardoc structure and the flat rates. Ask for written confirmation of the update of items and combination rules. Without this, your invoices go out with the wrong items.
Updating items. Go back over your catalogue of usual procedures and replace the old items with the new ones. Keep a record of each correspondence.
Training the secretarial staff. The staff who enter or check billing must know the combination rules. Plan for half a day of training and a written step-by-step guide for frequent cases.
Informing patients. Explain in a few lines, at reception or on the website, that billing follows a new tariff structure. This avoids questions about invoices that differ from one year to the next.
Coordination with insurers. Follow the first rejection feedback. A recurring reason often reveals an error in item or combination that needs to be corrected at source.
Before/after example for a typical general practice, 4,000 consultations per year. Before: you compare the average billed per consultation under Tarmed. After: you redo the calculation on the same basis with Tardoc. If the average difference is CHF 2.00 per consultation, the annual effect is CHF 8,000. This figure is an example of method: replace it with your own billing data, as no official average difference is guaranteed for any given practice.
Compliance checklist
To do, with a deadline for each point:
- Confirm the software update in writing with the vendor: now.
- Test 30 to 50 real invoices under Tardoc and compare with the old calculation: within 30 days.
- Classify your 20 most frequent procedures between Tardoc and outpatient flat rate: within 30 days.
- Train the secretarial staff on the combination rules: within 45 days.
- Check the tariff point value of your canton: at each agreement.
- Review the insured income of your loss-of-earnings cover if your activity changes: at the next annual review.
Official sources to consult regularly: the FMH (fmh.ch), the OAAT, the FOPH (bag.admin.ch) and the legal text at fedlex.admin.ch. Information verified on 27 October 2026, as some arrangements may still change.
"This article, published by MedCourtage (FINMA F01502264), presents the differences between TARDOC and TARMED for self-employed doctors for information purposes only; it does not constitute personalised legal, tax or insurance advice, and does not replace the advice of a qualified professional."
FAQ
No. Tardoc is a new fee-for-service tariff structure, with redescribed services, recalculated durations and new combination rules. It coexists with outpatient flat rates, which make up the other half of the reform.
The point value remains set by canton, between service providers and insurers. It therefore varies from one canton to another. Check the value applicable to your practice with your cantonal medical society.
Cost neutrality applies to the system as a whole, not to each practice. Your income may rise or fall depending on your activity profile. Test your own invoices to measure the real effect on your practice.
This depends on the list of approved flat rates. Specialists who perform technical procedures or repetitive outpatient interventions are the most affected. Consult the official list on the OAAT and FOPH (OFSP) websites.
Contact your vendor immediately and ask for written confirmation of the update of items and combination rules. Without an update, your invoices risk rejection by insurers and payment delays.
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