Is my psychotherapy treatement unusually expensive?

Family, Education, Health and Pets
1
I recently had 2 sessions (50 minutes each) and had to cancel 1 session at late notice due to a problem with public transport. I have now been charged a total of CHF 502 for this. CHF 412 for the 2 sessions I attended, and CHF 90 for the one I missed.

I am absolutely sickened by this amount. I've never, ever had a doctor in Switzerland even remotely this expensive.

I know I should have checked this all out before agreeing to the treatment, but I was given the documents to sign on the first day of treatment as soon as I arrived at her practice. I was anxious and worried (hence visiting the doctor) and my German skills arean't terrific.

Can anyone confirm if this is an unusual amount to pay for such treatment?

I should also point out that I dropped this particular doctor after the 2nd time seeing her as I didn't like her (she actually made me feel worse somehow).

2
Most psychotherapists have their prices listed on their website and always are mentioned before starting therapy.

Price seems about standard if maybe on the higher side ( usually 150-200 per hour ). I think it's quite considerate they only charge you half for a missed appointment, plenty of places would charge you the full price.

A cheaper way of going about it is to find a psychiatrist and get a diagnosis. This way your health insurance will cover the costs. They are harder to find though.

3
I feel that's expensive. I pay 160.- for 60 minutes. The payment for a missed appointment is your fault, so that's understandable. 206.- for 50 minutes would make anyone feel worse.

Are you referred by your GP? Or are you able to claim this against your health insurance?

4
Yes, based on my experience 200chf/hour is the going rate for a psychiatrist in Zurich/Zug area.

5
I was referred by my GP, but I have the basic insurance so this comes out my own pocket.

6
The full price for a missed appointment is CHF 150. So I am unsure exactly how this all adds up to CHF 502

My health insurance does "cover the costs", but since I have a CHF 2500 deductible, this is fairly meaningless.

The prices are not on her website at all. I was only presented them in a lengthy document, in German, just before starting the first session. I had told her in advance that my German isn't that good.

7

Oh, I’m sorry to hear it made you feel worse to go there. In that case, good that you stopped.

Being charged for an appointment that you missed is usual. Many doctors and therapists charge the full amount when patients cancel at short notice. This is because the shorter the notice, the less chance they will have to fill that slot with another patient or client. They still need to earn their living, so this is generally regarded as fair practice. The more generout therapists charge, as yours did, only a reduced fee for missed appointments.

The rate of Fr. 206 per 50-minute appointment isn’t super cheap, and is a bit more than is perhaps usual. The rates are, however, not fixed, and can vary from therapist to therapist.

During the past few years, there’s been a great deal of debate in Switzeralnd about whether or not a patient should first have a doctor’s certificate to receive psychotherapy from a psychologist whether or not psychologists should work under the authority of a doctor or by their own professional decisions the way in which such matters influence the extent to which a medical insurance company will or won’t reimburse those costs to the patient. Here, for example, is one report about a provisional tarif agreement, specifying Fr. 154.80 per hour, although some psychologists consider this too low, and the report adds that this is a first step, so that psychologists can then go on to specify other costs.
https://www.psychologie.ch/medienmit…arif-ab-1-juli
It could be that psychologists (just like doctors) charge additional fees for work such as opening a file on the patient, for reading reports about that patient, for phonecalls and mails, etc.

You will have to settle the bill because, as you say, you didn’t check the tarifs before you started, and so you’re bound. However, I recommend that you submit the bill you’ve received from the psychologist to your medical insurance company, and ask them to cover the costs. They may, or may not, or may cover part of the costs. This uncertainty is very annoying, but is part of this ongoing discourse which is not yet fully settled.
Oops, sorry, just saw this:

8
Thanks for the kind words. Honestly, on that day, when given the contract, I was in such a state mentally that I would have signed anything to get to talk to someone.

Given how expensive this is, I won't try again. I feel so broken at the moment, but paying so much to get better is just going to make me feel worse. I've barely seen my family for 3 years and live alone, and that CHF 500 could easily have covered my flights.

9

Www.deepl.com

10
Was this person a 'psychotherapist' or a 'psychiatrist' ?

To get mental health appointments covered, you need a mental health referral from your doctor and should go to a psychiatrist.

Tell your doctor. They should find a way for you to get psychiatric appointments via health insurance, but it may take longer to get an appointment...

11
It shouldn't, usually. Of course the franchise applies. The recommended thing to do is contact your health insurance beforehand.

As to the cost, it looks pricey. Uni ZH Psychological and Psychiatric Clinic charge 2% of your gross income per 50min, provided that's within the 100-250 range.

I wonder how the doc justifies 150 for a missed appointment. It's their obligation to minimise the damage (cost to the client), clearly at least part of the time can be used elsehow (study stuff or whatever) and thus the damage partially eliminated.

It might also be revealing to learn what the Uni ZH people think about OP's doc's bill. Or contact the cantonal health department, but they might not be subject to the doctoral duty to keep privacy.

12
The law changed here over the summer. One no longer needs to get a referral via a psychiatrist and it’s now covered via basic insurance making treatment more accessible as less hurdles to jump but still pricey as OP shows.

13
Hi. Costs for psychotherapy are usually between 150-180 CHF, but can go as high as 250 CHF for a 50 min appointment. Lesson learned: In the future, get a copy of anything you sign and put it through deepl for a translation (if it's in German). Better yet, take the paper home before you sign so that you know what you are signing.

As of 1 July 2022, the law regarding psychotherapy has changed to what is called an "Anordnungsmodell." All licensed psychotherapists have had to get re-licensed and jump through a lot of new bureaucratic hoops. What that means for someone seeking psychotherapy is: 1) find out if the psychotherapist in question is licensed for the Anordnungsmodell. If so, you can be billed over the Krankenkasse. With the add-ons (session, emails, reading your chart, updating your chart, etc) it comes to about 180 CHF per session. 2) You will need a referral from your GP or a psychiatrist. Most psychotherapists will give you a form to take to them and have signed. 3) After every 15 hours of therapy, another form, or even a formal report, is needed.

Some licensed psychotherapists are opting out from using the Anordnungsmodell, so you would need to verify if they do indeed bill over the Krankenkasse.

Many people have a portion of their psychotherapy paid with the supplemental insurance (Zusatzversicherung). Due to the new psychotherapy model, some supplemental insurances will no longer cover psychotherapy. If you go over the supplemental insurance, you would have to ask your insurance company if the supplemental insurance will continue to cover a portion of the cost or not. If you use supplemental insurance for psychotherapy, you still need a referral from your GP or a psychiatrist.

Some psychotherapists are not licensed to go over the Krankenkasse. If you go to a psychotherapist who is not licensed, you would pay the total fee out of pocket. It is difficult to get licensed in CH if you are a psychotherapist from another country as it is difficult to get your credentials from abroad recognized and accepted here. Again, a lot of bureaucratic hoop jumping.

I hope that you find a psychotherapist who speaks English and feels like a good fit for you. All the best.

14
I am very sorry for you.

In my opinion so many people are too concerned about making money even the in the medical field.

In my opinion if you are having a hard time the therapist should be making every effort to help .

I am basically retired now. I have been a coach for 24 years. I always kept my focus on the client and how I could help.

15
Well yes and then there is the reality of offering services for a price you deem acceptable based on what you invested in your qualifications and market rate (demand and supply and regulations make the price).