Psychotherapy costs basic insurance almost one billion

Psychological psychotherapy cost the compulsory health insurance scheme 991 million Swiss francs in 2025. That is 7.7 percent more than in the previous year. The increase is therefore markedly weaker than immediately after the change of billing model: in 2023 costs had still risen by 36.4 percent. So the bill has not fallen. It is only growing more slowly.

The monitoring published on 2 November by the Federal Office of Public Health (FOPH) and the Swiss Health Observatory Obsan runs up to 2025. Compared with 2021, the last full year before the reform, the increase amounts to 463 million francs, or just under 88 percent. How much of that is due to additional treatments cannot be read from the total.

What is contained in the 991 million

The figures cover outpatient psychological psychotherapy billed through basic insurance. The statistics use gross costs: the deductible and the co-payment are not yet subtracted. The 991 million therefore does not simply correspond to the amount the insurers bear alone. Patients' cost sharing is also included.

Nor does it represent total spending on mental illness. Inpatient stays are excluded. Other medical psychiatric services are reported separately in the monitoring. Anyone who uses this figure to describe the costs of all psychiatric care is adding up different areas.

Per insured person, the cost of psychological psychotherapy rose from 60 to 106 francs between 2021 and 2025. This average distributes spending across all insured people, including those without therapy. It does not mean that a treated person was cared for for 106 francs.

A large part of the increase remains unexplained

Since 1 July 2022, appropriately licensed psychological psychotherapists have been allowed to bill basic insurance independently on a physician's order. Previously, reimbursement was tied to delegation by a physician. Services provided independently had to be paid for privately or through supplementary insurance outside this model.

The change of system therefore also shifted which bill a treatment appears on. Higher compulsory health insurance (OKP) spending does not automatically mean that health care as a whole has become more expensive to the same extent: part of it may be therapy that was previously privately financed. However, the new monitoring does not quantify how large this part is.

Obsan attributes around 30 percent of the cost growth since 2021 to higher tariffs and 6.4 percent to the higher number of insured people. The remaining 63.6 percent, around 294 million francs, cannot be broken down further with the available data. Shifts away from private financing, better access and other changes in demand may contribute. These possibilities are not individually proven causes with known shares.