With the TARDOC tariff, a new fee-for-service tariff is ready, which is expected to be introduced together with the outpatient flat rates from 2025. It is intended to replace the previous fee-for-service tariff TARMED, for which several revision approaches have failed.
Development history of the TARDOC and future prospects
In mid-2019, after 3.5 years of development, the FMH, in collaboration with curafutura and the Medical Tariff Commission UVG (MTK), submitted the new tariff structure TARDOC to the Federal Council for review. The jointly founded ats-tms AG served as the tariff organisation for the development of TARDOC.
Even then, however, the tariff was rejected for the first time by the Federal Council due to various shortcomings. Since 2019, the tariff partners have submitted the new TARDOC tariff structure to the Federal Council for review a total of four times, the last time in December 2021 in version 1.3. In June 2022, however, this version was also rejected because too little account had been taken of the adjustment recommendations of the Federal Office of Public Health FOPH.
With the cost containment package 1a passed by Parliament, the legal starting position has changed since 1 January 2022. Since then, Art. 47a KVG states that service providers and insurers must establish an organisation dedicated to the development and maintenance of tariff structures for outpatient medical treatment. With the founding of the “Organisation ambulante Arzttarife AG”, OAAT AG for short, this mandate was fulfilled at the end of 2022. Within the framework of this foundation of an outpatient tariff organisation in which all tariff partners are involved, the goal was also defined of introducing the TARDOC together with the outpatient flat rates at the beginning of 2025. At the beginning of December 2023, the TARDOC was resubmitted to the Federal Council together with the outpatient flat rates.
You can find out more about current developments in the outpatient tariff system and various milestones in recent years on our knowledge page on the topic:
Structure and function of the TARDOC
The TARDOC tariff is intended to ensure that all outpatient medical services are charged according to the current state of knowledge. Thus, the cost models used to calculate the tax points were also updated. Likewise, the reference income, which serves as the basis for calculating the medical service, was updated with data from 2019. In addition, according to ats-tms AG, the new tariff structure is more flexible than TARMED and can be adapted quickly and easily in the event of new findings and medical innovations.
As with TARMED and also simultaneously with the inpatient sector, TARDOC only specifies the tariff structure. Accordingly, the TARDOC catalogue contains only a certain number of tax points for each service item. The TARDOC currently contains around 2630 tariff items. These are divided into 11 main chapters, 74 thematic chapters and 323 subchapters. The chapter structure is based on the medical specialities or body regions of the human being. The example of a spirometry, a lung function test, serves to illustrate and better understand the four levels:
- Main chapter: T Chest area
- Chapter: TG Lungs, Airways
- Subchapter: TG.05 Lung function
- Individual tariff heading: TG.05.0030 Small spirometry
Based on the tariff structure, the tariff partners (service providers and payers) negotiate the so-called tax point value. The effectively reimbursed Swiss franc amount for a service is then calculated by multiplying the number of tax points (according to TARDOC) by the cost neutrality factor (“external factor”) and the negotiated tax point value. The cost neutrality factor is also negotiated between the tariff partners in order to guarantee a cost-neutral transfer (in accordance with the requirements of the KVG) of TARMED to TARDOC.