Alternative practitioner invoice Switzerland

The most important things in brief

• Medical treatments can be exempt from tax. Art. 21 VAT Act and Art. 34–35 VAT Ordinance require an examination of the service and cantonal licence or authorisation.
• Assess registration and services separately. Voluntary or continuing registration can exist below CHF 100,000; exempt medical treatments generally do not count towards qualifying threshold turnover.
• AHV and VAT are different tests. The compensation fund assesses self-employment; Contributions are based on income and applicable rules, not the VAT turnover threshold.
• The QR-bill has been standard since October 2022 and has replaced the old ISR bills. It is not mandatory on every bill, but without a QR code, patients type in the payment details by hand.
• There is no equivalent general German GebüH fee schedule in Switzerland — you release your fees. Depending on the canton, discipline and length of the meeting, usual rates are in the mid-three-digit range per meeting.

If you work as a self-employed alternative practitioner in Switzerland - or are planning to become self-employed - the bill is the point at which tax law, professional law and day-to-day practice collide. Missing mandatory information can trigger an FTA complaint. Incorrect VAT treatment costs you money. An invoice without a QR code results in delayed payments and unhappy patients.

This guide will guide you through everything you need for a correct Natural practitioner invoice Switzerland: invoice information under Art. 26 VAT Act, the VAT exemption for medical treatments, the AHV obligation for the self-employed, the QR-bill since October 2022 and a ready-to-copy invoice template. You get concrete examples, practical cases and references to the relevant laws.

This guide covers simple personal bills. You need a separate test for the tariff specifications of a supplementary insurance, technical patient documentation and the suitability of a system for health data.

Swiss invoice requirements: private receipts and Art. 26 VAT Act

For a detailed private invoice, the following structure is useful. For taxable services and VAT registration, observe the applicable Art. 26 requirements; explicitly VAT-inclusive amounts with the applicable rate are permitted. For exempt medical treatments, record the actual exemption reason separately.

1. Your name and address — full practice name, street, zip code, city. For a sole proprietorship, the name is sufficient; for other legal forms, the company name from the commercial register is required.
2. Recipient's name and address — Patient or, if applicable, an insurance body.
3. Date or period of service — the treatment day or period (plus the invoice date).
4. Quantity and description of services — e.g. “Classical homeopathy, initial consultation, 90 min” or “TCM acupuncture, 60 min”. Precise descriptions protect you during FTA exams.
5. Consideration — the agreed amount, net or explicitly VAT-inclusive.
6. Tax disclosure for taxable services when registered — generally rate and amount; for explicitly VAT-inclusive consideration, the applicable rate is sufficient.
7. Your VAT number (VAT number) — the UID-based number that the FTA assigns during registration.

If your treatment is VAT-exempt - provided the service and approval meet the legal requirements - you do not declare VAT, but record the reason for the exemption with a note, for example: "VAT-exempt in accordance with Art. 21 Paragraph 2 Number 3 VAT Act - Medical treatment through cantonal approval."

Check the actual commencement and effective end of registration and the specific service. The ordinary threshold is CHF 100,000 qualifying worldwide turnover excluding VAT; exempt turnover generally does not count. Voluntary or continuing registration can exist below it. Only without liability and effective registration should you omit VAT. A turnover fall alone does not end registration (Arts. 10, 11 and 14 VAT Act).

The Code of Obligations does not prescribe any specific invoice content. As a good practice, the same information should be included on every invoice even without VAT obligation: who, to whom, what, when, how much and by when payable - plus an invoice number. Then you are on the safe side. You can find the OR in the official collection of the Swiss Code of Obligations.

The QR-bill: replacing the old payment slips

Since 1. October 2022, the QR-bill is the only accepted payment slip format in Switzerland. The old orange and red ESR notes are no longer valid. Every invoice you issue should contain a QR-bill payment part with the Swiss QR Code.

The QR code encodes your IBAN or QR-IBAN, the amount, your name and a reference (with QR-IBAN, a QR reference is mandatory). Patients scan it with their banking app and banks process it automatically. Without a QR code, there is a risk of manual payment delays and queries. How you specifically create such a payment part can be found in our guide to Creating a QR-bill. You can find a neutral template for the invoice structure in the Swiss invoice template.

VAT: Check medical treatment and insurance coverage separately

The tax exemption depends on the service and the authorization of the service provider, not just on who pays or whether there is a prescription. Art. 21 paragraph 2 number 3 VAT Act and Art. 34 and 35 VAT Ordinance distinguish medical treatments from pure wellness or performance improvement offers and mention the cantonal licence or authorisation. A prescription for an insured event is a different test.

• Medical treatment: specific health assessment, treatment or prevention in the legal sense, by appropriately licensed specialists. Exempt from tax if the requirements are met.
• Other offers: Pure wellness is not automatically a healing treatment. For courses, a possible educational exception must be checked separately; for product sales, the rate depends on the goods. Not every offer outside of treatment carries a flat rate 8.1%.
• Registration: Sales exempt from tax generally do not count towards the relevant sales for the usual CHF 100,000 threshold. For other services, the relevant global turnover, start of activity and any voluntary registration must be checked.
• Input tax: Registration alone does not allow for input tax deduction on expenses for services exempt from tax. In the case of mixed activities, the assignment or correction must be checked.

Document the classification professionally, but do not unnecessarily transfer diagnoses or treatment reports to general accounting software. For a non-taxable or VAT-exempt service, do not write “8.1% = CHF 0.00”: Describe the relevant reason. Only use the standard rate for services that can actually be classified as such and if the registration status is appropriate.

Fees and pricing: free tariff setting in Switzerland

Here is a key difference to the German alternative practitioner profession: There is no equivalent general German GebüH fee schedule in Switzerland - no fee schedule that tells you what you can charge for which service. You have free tariff planning. You set your own fees.

This is a blessing and a curse at the same time. Calculate your private prices based on costs, time and scope of services. The following amounts are illustrative prices for calculation, not industry tariffs:

The ranges vary depending on canton, experience, specialization and type of practice (individual company, group practice). Zurich and Geneva tend to be at the higher end, while rural cantons are at the lower end.

If you become self-employed, you usually set up a sole proprietorship — the simplest legal form for alternative practitioners. No share capital, no commercial register entry (less than CHF 100,000 turnover), full control. Most independent alternative practitioners in Switzerland work in this form.

Fictional example 1: Sarah from Zurich

Fictional example: Sarah calculates practice expenses and treatment time to set her fees. Low turnover alone does not determine VAT: she checks the service and professional authorisation as well as any voluntary or continuing registration.

AHV and social insurance: Obligations for the self-employed

Register your self-employment with the responsible compensation fund for assessment. Whether and which contributions are owed depends on income, employment situation and the applicable exceptions - not on the VAT turnover threshold.

AHV registration: this is how it works

1. Register with the compensation fund - the cantonal or a recognized industry-specific compensation fund. This can be done online or in writing.
2. Submit the business details - business form (sole proprietorship), address, activity, if applicable commercial register number.
3. The compensation fund determines your contribution - based on your self-employment income subject to AHV. The contribution rate for AHV/IV/EO is around 10% (lower for low incomes), plus, depending on the canton, there are administrative costs and FAK contributions.
4. You pay contributions on account - the compensation fund requires advance payments in the first year, which are later offset against the actual billing.
5. Submit the annual statement — at the end of each year, you submit a profit and loss statement. The compensation fund offsets the payments on account and demands additional payments or refunds any excess.

The compensation fund will assess whether you are considered self-employed for social security purposes based on your actual circumstances. Own invoices or a specific job title alone are not enough. The current rules and contribution scales can be found in the Information sheet 2.02.

The leaflet AHV/IV contributions for the self-employed provides detailed information.

Fictional example 2: Markus from Bern

Fictional example: A practice reports late to the compensation fund. She must provide proof of status and income and clarify any outstanding contributions. Plan contributions on account based on the current cash calculation; the maximum rate of 10% is not a correct rule of thumb for any income.

QR-bill for alternative practitioners: this is how it works

The QR payment part replaces the old payment slips and consists of a payment part on the right and a receipt slip on the left. It is a payment aid, not a general obligation on every practice invoice.

What the QR-bill contains

The QR code encodes the following data:

• IBAN or QR-IBAN — a normal IBAN with SCOR reference or without reference; a QR-IBAN only together with a QR reference.
• Beneficiary — your name and address.
• Payment reference — for QR-IBAN, a QR reference with 27 digits including check digit; with normal IBAN SCOR or no reference.
• Amount — if entered, the amount is coded; otherwise the patient can enter it.
• Further information — e.g. Invoice number, customer number, message.

Patients can scan the QR code in their banking app or use it at the bank counter. They must still check and authorise payment; scanning alone neither executes nor proves payment.

Practical tips

• Check account variant — a normal IBAN is sufficient for a QR-bill with SCOR or without reference. The bank will clarify whether you need a QR-IBAN for QRR.
• Use software with a QR generator — creating the QR code manually is error-prone and takes time. Good software generates the QR code automatically.
• Check the reference variant — an invoice number alone is not a valid QRR. Generate a valid 27-digit reference including check digit for a QR-IBAN; use SCOR or no reference with a normal IBAN. Matching is not guaranteed by a reference alone.
• Reconcile advance payments — compare already invoiced and paid amounts with the total service. Applying a payment is not automatically a VAT-reducing price credit.

Fictional example 3: Lena from Basel (part-time)

Invoice template for alternative practitioners

Fictional, non-payable layout for an exempt private medical treatment. It assumes the appropriate service and professional authorisation. Limit health data to what is necessary for this private receipt.

═════════════════════════════════ ══════════════════════════════════
                       PRACTICE [NAME]
                   [Street No.]
                  [ZIP code city], canton [XX]
                   Tel: [number] · Email: [email]
                   UID/VAT number: [own applicable details only when registered]
═════════════════════════════════ ══════════════════════════════════

INVOICE No. 2026-001
Date: [DD.MM.YYYY]

Invoice to:
[patient name]
[Street No.]
[ZIP code city]

Customer Reference: [only if necessary; no unnecessary health data]
Prescription reference: [only if required for this private receipt]

───────────────────────────────── ──────────────────────────────────
Item │ Description │ Amount CHF
───────────────────────────────── ──────────────────────────────────
1 │ Classical homeopathy, initial consultation, 90 min │ 220.00
2 │Organ examination, extensive │ 45.00
───────────────────────────────── ──────────────────────────────────
                                          Subtotal: 265.00
                                          VAT: —
                              (exempt according to Art. 21 Para. 2
                               Paragraph 3 VAT Act – medical treatment
                               with cantonal approval)

Total: 265.00
───────────────────────────────── ──────────────────────────────────

Payable by: [date + 30 days]
Bank details: [Name of bank] QR-IBAN: [CH.. .. ..]
Reference: [27-digit QR reference including check digit, only with QR-IBAN]

Thank you for your trust.
Kind regards, [Signature / Name]

═════════════════════════════════ ══════════════════════════════════
           [QR-bill payment part with Swiss QR Code]
═════════════════════════════════ ══════════════════════════════════

This additional example expressly assumes a VAT-registered practice and an independent service at the standard rate that is not covered by the education exemption. Workshops are not automatically taxable:

3 │ Non-medical one-to-one wellness consultation │ 180.00
     (Service subject to VAT, not medical treatment)

VAT 8.1%: 14.58
                                          subject to VAT
                                          Total: 194.58
───────────────────────────────── ──────────────────────────────────
                                          Total invoice: 459.58
───────────────────────────────── ──────────────────────────────────

Clearly separate medical treatment and other services. The FTA wants to identify which amounts are VAT-exempt and which are not. If you mix both in one position, examiners will demand a realignment - which, in the worst case, will result in a complaint.

Simple private invoice or practice software?

General invoicing software can help with simple private invoices. That does not make it a clinical patient-record system, a prescription register or an interface for KVG/UVG insurance billing. A valid invoice does not guarantee insurance cover.

Outside of general customer administration, keep the technical documentation and the necessary proof of insurance in the appropriate system. Check access rights, data minimization, order processing, and health data eligibility before collecting such data anywhere. Only the information necessary for its purpose should be included on the private invoice.

Compare the documented functions of the invoicing software and the prices with your actual needs. These instructions do not assume that prescriptions, tariff codes, cost-coverage approvals, remaining entitlements and payment reconciliation are automatically supported.

Conclusion

For your private bill you need a clear list of services and amounts. Check VAT based on the service and your professional authorisation as well as registration; insurance approval is a separate issue. A QR payment part can make paying easier, but does not certify recognition by insurers or FTA.

Separate medical treatment and other offers from a technical and tax perspective. A switch in invoicing software does not decide whether the requirements for the tax exemption are met.

Register with the compensation fund early - before the first bill, not just when the mail arrives. And calculate your fees so that practice expenses, AHV contributions and your income come together. Free tariff design means: You can - but you also have to do the math.

For simple private invoices you can check the invoicing software. Clinical files and insurance bills belong in demonstrably suitable systems.

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References: ESTV - VAT information on healthcare · AHV/IV - self-employed contributions · VAT Act.