TARMED

What is TARMED?

TARMED is short for “Tarif médical” (medical tariff). It was the uniform Swiss tariff structure under which outpatient medical services covered by basic health insurance were billed, both in medical practices and in hospital outpatient departments. Anyone who received a doctor’s bill between 2004 and the end of 2025 found TARMED items on it, each with a number, a description and a number of tax points.

Before 2004, each canton had its own medical tariff. TARMED replaced these cantonal tariffs with a single structure. Only the valuation of services in tax points was uniform, however. The value of a tax point in Swiss francs, the point value, continued to differ from canton to canton. That is why the same consultation did not cost the same in every canton.

TARMED has no longer applied since 01.01.2026. It was replaced by two new tariff structures: TARDOC for services billed item by item and the outpatient flat rates for more complex treatments paid as a package. Inpatient hospital stays were never covered by TARMED; they have been billed under SwissDRG since 2012.

You still need the term in three situations today: when you check an older bill, when you only now receive a bill for treatment in 2025, or when you read reports about the tariff reform.

How it works

Tax points times point value

Each service in TARMED had a tariff item, for example for the first minutes of a consultation, for an X-ray or for a minor procedure. Each item was valued in tax points, split into two parts:

• Medical service (AL, ärztliche Leistung): the work of the doctor, depending on time spent and qualifications.
• Technical service (TL, technische Leistung): the rooms, equipment, staff and materials needed for the service.

For the bill, the tax points for AL and TL were added together and multiplied by the cantonal point value. The point values were negotiated by the cantonal tariff partners, i.e. medical associations and insurers, and approved by the competent authority.

Who set TARMED

In basic health insurance, tariffs are a matter for the tariff partners: associations of service providers and of insurers agree them in a tariff agreement, and the Federal Council approves agreements that apply throughout Switzerland. With TARMED, the tariff partners failed for years to agree on a complete revision. The Federal Council therefore stepped in in 2014 and 2017 using its subsidiary power and adjusted the structure itself; from 01.01.2018, TARMED applied as a tariff structure set by the Federal Council.

Why TARMED was replaced

According to the Federal Office of Public Health (FOPH), TARMED no longer reflected current medicine. Technical progress had made many examinations quicker, but the tax points had stayed the same. As a result, some services were overvalued, while others, for instance in primary care, were undervalued. With more than 4,600 items, the structure was also hard to keep track of.

On 18.06.2021, in cost-containment package 1a, Parliament decided that outpatient flat rates take precedence over fee-for-service tariffs and that the tariff partners must set up a joint tariff organisation. This organisation for outpatient medical tariffs (OAAT AG) was founded in November 2022. The Federal Council approved TARDOC and the outpatient flat rates on 30.04.2025 and adjustments on 05.11.2025. They have been in force since 01.01.2026.

	TARMED	TARDOC	Outpatient flat rates
Valid	01.01.2004 to 31.12.2025	since 01.01.2026	since 01.01.2026
Principle	individual services	individual services	one fixed amount per treatment
Scope	more than 4,600 items	around 1,400 items	around 300 flat rates
Typical use	all outpatient medical services	primary care, simple infrastructure	complex treatments, mainly in hospitals

Legal basis

The basis for all tariffs in basic health insurance is Art. 43 of the Federal Health Insurance Act (KVG). Under para. 1, service providers draw up their bills according to tariffs or prices. Para. 2 let. b describes the fee-for-service tariff, as TARMED was: tax points are set for each service and the point value is determined. Para. 2 let. c and para. 3 allow flat-rate tariffs. Under para. 4, tariffs are agreed in tariff agreements; under para. 5, fee-for-service tariffs and outpatient flat rates per patient must each be based on a single tariff structure that is uniform throughout Switzerland. If the tariff partners cannot agree, the Federal Council sets it; para. 5bis allows it to adjust a structure that is no longer appropriate. This was the basis on which it intervened in TARMED.

Art. 47a KVG obliges the associations to set up a joint organisation, with equal representation, for outpatient medical tariffs. Art. 59c para. 1 let. c of the Health Insurance Ordinance (KVV) requires that a change of tariff model does not cause additional costs. Important for you as a patient are Art. 42 para. 3 KVG, under which you receive a detailed and comprehensible bill or a copy of the invoice, and Art. 44 KVG, the tariff protection rule: doctors and hospitals may not charge more than the tariff for services covered by basic health insurance.

Example: a bill spanning the turn of the year

Sophie, 58, sees her GP twice, in December 2025 and in January 2026. The practice bills both visits at the end of January 2026.

Date of treatment	Tariff on the bill	Reason
15.12.2025	TARMED	treatment before the system change
12.01.2026	TARDOC	treatment after 01.01.2026

What counts is the date of treatment, not the date of the bill. The same applies to the deductible and the retention fee: the December visit counts towards the co-payment for 2025, the January visit towards the co-payment for 2026.

The tariff structure affects your premium only indirectly: it influences how much outpatient treatment costs in total, and these costs feed into premiums. The 2026 premiums of all health insurers for your municipality are shown in the premium calculator.

What this means for you

The switch from TARMED to TARDOC changes nothing about your insurance cover: basic health insurance pays for the same services as before. What is different is the bill. These points help you:

1. Check the copy of the invoice. You are entitled to a comprehensible bill or copy of the invoice. Check the date, the number of visits and whether the services actually took place.
2. Ask if anything is unclear. If you do not understand an item, ask the practice first. If something is wrong, report it to your health insurer. You can find the contact details of all health insurers under health insurers.
3. Look out for flat rates. Since 2026, for some outpatient procedures in hospital, the bill shows a flat rate instead of many individual items. This is correct and not an error.
4. Do not accept any surcharge. Because of tariff protection, a practice may not charge anything extra for services covered by basic health insurance.
5. Keep an eye on your costs. Your bills determine how much deductible and retention fee you pay. The deductible calculator shows whether a different deductible suits you; how to change health insurer is explained under switching health insurer.

Common mistakes

• Thinking TARMED items on a 2026 bill are wrong. If the treatment took place in 2025, TARMED is correct.
• Confusing the tariff with the price. TARMED set the tax points; the amount in Swiss francs was determined by the cantonal point value.
• Believing the health insurer pays for fewer services under TARDOC. The tariff structure governs billing, not the scope of benefits of basic health insurance.
• Filing copies of invoices without checking them. Errors such as items billed twice are only noticed if you compare the copy with your appointments.

We explain how we calculate costs and premiums on this website under how we calculate.