[{"data":1,"prerenderedAt":171},["ShallowReactive",2],{"\u002Fblog\u002Fe-invoicing-in-swiss-healthcare":3},{"id":4,"title":5,"body":6,"description":162,"extension":163,"lastUpdatedAt":164,"meta":165,"navigation":166,"path":167,"publishedAt":164,"seo":168,"stem":169,"__hash__":170},"blog\u002Fblog\u002F0017.e-invoicing-in-swiss-healthcare.md","E-invoicing in Swiss healthcare: TARMED and special requirements",{"type":7,"value":8,"toc":152},"minimark",[9,13,16,21,24,35,47,50,54,60,63,82,85,89,100,103,107,114,117,120,124,127,130,133,137,140,143,146,149],[10,11,12],"p",{},"Healthcare invoicing in Switzerland operates in a world of its own. The billing standards used by doctors, hospitals, physiotherapists, and laboratories are not the same as the commercial invoice formats used in the rest of the economy. TARMED, TARPSY, ST Reha, and the various tariff systems that govern Swiss healthcare billing have their own XML schemas, their own transmission infrastructure, and their own rules about what data must appear and how.",[10,14,15],{},"This creates a genuine question for healthcare providers starting to look at e-invoicing: do the Swiss e-invoicing mandates — the federal B2G requirements, the SwissDIGIN PEPPOL profile — apply to healthcare billing? And if not, what does apply?",[17,18,20],"h2",{"id":19},"the-two-separate-worlds-of-swiss-healthcare-billing","The two separate worlds of Swiss healthcare billing",[10,22,23],{},"Swiss healthcare billing splits into two categories that barely overlap.",[10,25,26,30,31,34],{},[27,28,29],"strong",{},"Billing to insurers"," — health insurers (Krankenkassen) under the KVG (Krankenversicherungsgesetz) and accident insurers under the UVG — is governed by the specific tariff systems and the associated data standards. The dominant standard for electronic transmission is ",[27,32,33],{},"MediData",", a Swiss network platform that routes claims from providers to insurers. MediData uses its own XML format (the MediData XML invoice) based on the respective tariff structures. This system handles the majority of healthcare billing volume in Switzerland and has been electronic for years — in some respects, healthcare was ahead of other sectors in adopting electronic document exchange.",[10,36,37,40,41,46],{},[27,38,39],{},"Billing to public sector bodies for non-clinical services"," — facility management services to a cantonal hospital, IT services to a federal health authority, supplies to a government-funded care home — falls under the same B2G e-invoicing rules as any other supplier. From 2026, these invoices to federal bodies must be submitted electronically via ",[42,43,45],"a",{"href":44},"\u002Fblog\u002Fchoosing-between-ebill-and-peppol-for-your-business","eBill or PEPPOL",".",[10,48,49],{},"The confusion arises because many healthcare organisations do both. A hospital bills health insurers via MediData for clinical services and also invoices the federal government for research grants, infrastructure subsidies, or service contracts. The MediData billing is unaffected by the Swiss federal e-invoicing mandate. The government contract invoices are affected.",[17,51,53],{"id":52},"how-tarmed-works","How TARMED works",[10,55,56,59],{},[27,57,58],{},"TARMED"," (Tarif Médical) is the tariff system used for outpatient medical services across Switzerland. It is a catalogue of over 4,600 service positions, each identified by a unique code (Tarifposition), with a defined number of technical value units (TL) and medical value units (AL) per position. The invoice is a list of services rendered, each referenced by its TARMED code, with the applicable unit values multiplied by the applicable cantonal point values to produce the CHF amount.",[10,61,62],{},"A TARMED invoice to an insurer must contain, among other things:",[64,65,66,70,73,76,79],"ul",{},[67,68,69],"li",{},"The treating physician's GLN (Global Location Number) and ZSR number (Zahlstellenregister — the Swiss provider identifier for billing purposes)",[67,71,72],{},"The patient's insurance card number and insurance identifier",[67,74,75],{},"The treatment date and session number",[67,77,78],{},"Each service position rendered, with its TARMED code, quantity, and calculated amounts",[67,80,81],{},"The diagnosis codes in ICD-10 format (for certain service types and for statistical purposes)",[10,83,84],{},"None of this maps to a PEPPOL BIS Billing 3.0 invoice. TARMED invoices are transmitted as structured XML via MediData's network directly to the insurer, and the insurer processes them against the patient's coverage. The concept of a purchase order reference, a buyer VAT number, or a PEPPOL participant ID does not apply here.",[17,86,88],{"id":87},"tarpsy-and-st-reha-for-inpatient-billing","TARPSY and ST Reha for inpatient billing",[10,90,91,92,95,96,99],{},"Inpatient psychiatric billing uses ",[27,93,94],{},"TARPSY"," and inpatient rehabilitation uses ",[27,97,98],{},"ST Reha"," — both are DRG-adjacent systems (the main acute inpatient system is SwissDRG) that bill on the basis of a case rather than individual service positions. A hospital invoices the insurer for a complete inpatient stay, referencing the applicable case group and associated point value.",[10,101,102],{},"Like TARMED, these systems use MediData for electronic transmission and follow their own XML schemas. They are entirely separate from the commercial e-invoicing world.",[17,104,106],{"id":105},"what-vat-applies-to-healthcare-services","What VAT applies to healthcare services?",[10,108,109,110,113],{},"Most Swiss healthcare services provided by qualified professionals under the KVG are ",[27,111,112],{},"exempt from VAT"," under Art. 21 MWSTG. This means the provider neither charges VAT nor can claim input tax credit on purchases related to exempt supplies. The invoice shows the service amounts without a VAT line.",[10,115,116],{},"The exemption covers medical treatment, hospital stays, nursing care, physiotherapy by registered physiotherapists, and a range of other services. It does not cover all services a healthcare organisation might provide — cafeteria sales, parking, rental income, consultancy to third parties, and pharmaceutical sales at commercial pharmacies are typically subject to standard VAT.",[10,118,119],{},"For healthcare organisations that have both exempt and taxable activities, input tax must be apportioned — a complication that affects how invoices from suppliers are processed internally, though it does not change what appears on outbound invoices.",[17,121,123],{"id":122},"the-b2g-mandate-and-healthcare-providers","The B2G mandate and healthcare providers",[10,125,126],{},"Hospitals, clinics, and other healthcare providers that also supply goods or non-clinical services to federal or cantonal government bodies are subject to the e-invoicing mandate for those supplies. A hospital providing facility management services to a federal research institution, for example, must invoice those services electronically from 2026 if they exceed the relevant thresholds.",[10,128,129],{},"In practice, this means healthcare organisations need to identify which of their customer relationships are subject to the mandate and ensure their billing system for those relationships can generate PEPPOL BIS or eBill invoices. This is a different system from their clinical billing infrastructure and does not require changes to MediData connectivity.",[10,131,132],{},"For cantonal public hospitals (Kantonsspitäler), there is an additional consideration: they may themselves be subject to cantonal e-invoicing requirements for their procurement. When they are on the buying side — receiving invoices from medical equipment suppliers, pharmaceutical companies, or facility management firms — the canton may require those suppliers to submit structured invoices. This is driving some Swiss healthcare suppliers to implement PEPPOL connectivity even if the federal mandate does not directly apply to them yet.",[17,134,136],{"id":135},"practical-implications-for-healthcare-organisations","Practical implications for healthcare organisations",[10,138,139],{},"If you work in finance or IT at a Swiss healthcare provider, the practical picture looks like this:",[10,141,142],{},"Your clinical billing to KVG and UVG insurers goes through MediData and is not affected by the federal e-invoicing mandate. No changes needed on that side.",[10,144,145],{},"Any invoices your organisation sends to federal government bodies for non-clinical services must be electronic from 2026. Check whether your ERP or billing system for those relationships supports eBill or PEPPOL. If it does not, this is where the work sits.",[10,147,148],{},"If your organisation is a significant supplier to cantonal hospitals or other healthcare institutions, expect those buyers to start requesting structured invoices as their own procurement systems modernise — not necessarily on a federal mandate timeline, but on a canton-by-canton basis over the next few years.",[10,150,151],{},"The specialist clinical billing systems your organisation uses — whether MediData, a hospital information system, or a practice management tool — are well-established and unlikely to change format soon. The e-invoicing gap in healthcare is almost entirely on the non-clinical side: facility contracts, equipment purchases, professional services, and anything else billed outside the tariff systems.",{"title":153,"searchDepth":154,"depth":154,"links":155},"",2,[156,157,158,159,160,161],{"id":19,"depth":154,"text":20},{"id":52,"depth":154,"text":53},{"id":87,"depth":154,"text":88},{"id":105,"depth":154,"text":106},{"id":122,"depth":154,"text":123},{"id":135,"depth":154,"text":136},"The specific invoicing standards and data requirements for healthcare providers billing insurers and patients in Switzerland.","md","2026-06-24",{},true,"\u002Fblog\u002Fe-invoicing-in-swiss-healthcare",{"title":5,"description":162},"blog\u002F0017.e-invoicing-in-swiss-healthcare","vRLL4PbgX6YgDgF1NSd8ou_kAaWUMMGXYZu6CEGxnyM",1785055540112]