Psychotherapy sessions soon reimbursed through basic insurance – rts.ch

From July 1, psychologists trained in psychotherapy will be able to be reimbursed through basic insurance. This reform must meet the growing needs of the population in terms of mental health. However, psychologists and insurers are unable to agree on a rate.

Associations of psychologists, H + Swiss Hospitals, Curafutura and the HSK Purchasing Community announced on Tuesday night that they had reached a tariff agreement. The Confédération et aux cantons de fixer is now requested for the whole of Switzerland, this tariff structure and this conventional tariff, in the interest of patients.

The HSK Community of Purchasing is a self-employed joint-stock company which, on behalf of Helsana, Sanitas and the CPT, purchases medical services under compulsory health insurance. It represents 2 million basic insurance. Curafutura is the association of health insurers CSS, Helsana, Sanitas and KPT.

Improve the situation of approving psychotherapeutic benefits and facilitating access to care, the Federal Council decided that, from 1 July, psychological psychotherapy should be able to be covered by basic insurance. , provided it is prescribed by a doctor and under certain conditions.

Appeal to other insurers

In order to introduce the new model (the so-called prescription model), the associations of psychologists and H + conducted intense negotiations with Curafutura and the HSK Purchasing Community to find an agreement on an adequate tariff structure and value. “Tariff partners regret that a whole-branch agreement could not be found and urge other insurers to ally themselves with the now transitional solution,” the statement said.

The rate has been set at 154.80 francs per hour and is valid until 31 December 2024. Data on benefits and costs required to fix a final solution.

Dans un même temps, this transitional solution of the advantage of allowing the implementation of the prescription model from 1 July.

The current bare system does not allow psychotherapists to charge their basic insurance benefits unless they are employed by a psychiatrist in a practice or clinic and practice in a delegation.

“The delegation rate that prevails to date is based on Tarmed, an outdated tariff structure and a model based on employee activity in a practice or clinic. This will change in the future, thanks to the prescription model, ”reads the statement.

Measures to prevent a rise

In amending the ordinance, the Federal Council explained that measures are in place to avoid unjustified benefits. A medical prescription entitles you to a maximum of fifteen sessions of psychotherapy. It can be renewed once.

Beyond these 30 sessions, a report must be sent to the insurer’s doctor to extend the therapy. Until now, the number was set at 40.

According to estimates by the Federal Council, 100 million francs will be reimbursed through basic insurance. Today, the costs are borne by the patients themselves and the supplementary insurance. In the long run, that figure could rise to about $ 170 million.

ats / fgn

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