TARPSY is the tariff system used in the area of inpatient psychiatry and regulates the reimbursement of psychiatric treatments uniformly throughout Switzerland. TARPSY was introduced on 1 January 2018 and has been mandatory for child and adolescent psychiatry since 1 January 2019.
As with the rest of the inpatient tariff structures, the TARPSY tariff system consists of two parts: The national tariff structure and the individual tariff agreements. All three inpatient tariff systems in Switzerland are based on this concept, as it is also described on the knowledge page on all inpatient tariff systems. In the following, we focus on the national tariff structure.
Structure and functioning of the TARPSY tariff
Based on certain criteria such as the main diagnosis, secondary diagnoses, procedures and some demographic characteristics such as age, each inpatient stay in a psychiatric hospital or department is assigned to a case group (PCG, Psychiatric Cost Group) with the help of the grouper. In contrast to the SwissDRG tariff system, the cost weights of a case group are not fixed. The TARPSY tariff system works on the basis of service-related degressive daily flat rates. In concrete terms, this means that the daily cost weight decreases with increasing length of stay.
Using the example below for PCG TP27B, it can be seen that the cost weight decreases differently from day to day in different phases. In the first phase (light grey), the daily cost weight decreases by 0.052 per additional day, in the second phase (green) by 0.006. In the third phase (dark grey) from 61 days of stay, the daily cost weight remains constant at 1.229. At the end, the number of days of stay is multiplied by the corresponding daily cost weight. For an exemplary stay of 48 days, this results in an effective cost weight of 62,256 (48 * 1,297).
In order to calculate the reimbursement for a hospital, the effective cost weight is finally multiplied by the base rate in CHF. This is also determined for TARPSY in the individual tariff agreements already mentioned.
As with SwissDRG or ST Reha, the concept of additional charges is also applied in TARPSY. Very expensive services, such as certain medicines, are additionally reimbursed. The additional charges are indicated in the tariff catalogue with an amount in Swiss francs in addition to the flat-rate reimbursement and are not part of the cost weights of the individual PCGs.
Like the other inpatient tariff structures, the TARPSY tariff structure is also based on real cost and service data from inpatient psychiatric institutions in Switzerland. The tariff is currently being further developed in a biennial rhythm. All adjustments and new versions of TARPSY must be approved by the partners of SwissDRG AG and, in accordance with the KVG, by the Federal Council.
The further development can be influenced via the TARPSY application procedure. eonum offers various services related to the TARPSY application procedure. You can find out more about them on the following offers page:
The currently valid catalogue of flat rates per case (TARPSY 4.0 2023) can be found here (only in German). Further information, especially on the definition of the individual PCGs, can be found in the definition manual. The currently valid definition manual of TARPSY version 4.0 as PDF can be found here (only in German). With the help of the online definition manual (only in German), which was developed by eonum on behalf of SwissDRG AG, the grouping logic can be understood even better.
More about the topic
Diagnoses must be coded for inpatient psychiatric cases using the ICD catalogue. Procedures (treatments) are documented using CHOP codes. Learn more about the two main underlying catalogues ICD and CHOP on our corresponding knowledge pages:
eonum offers various advisory services on inpatient tariffs in psychiatry and the TARPSY tariff structure. You can find more information on the corresponding offers page: