In Switzerland, physiotherapy may be covered either by compulsory health insurance or by accident insurance. Simple in theory, confusing quite quickly in practice: illness or accident? Nine sessions? Another prescription? And what happens if treatment needs to continue for longer?
Here are the main rules, without unnecessary insurance jargon.
A physiotherapy prescription usually covers 9 sessions
Under compulsory Swiss health insurance (KVG/LAMal), physiotherapy is covered when it is prescribed by a doctor and provided by a physiotherapist who is authorised to bill compulsory insurance.
One prescription allows for a maximum of 9 physiotherapy sessions. The first session must begin within five weeks of the date the prescription was issued. If nine sessions are not enough, the doctor can issue another prescription.
How many times can a physiotherapy prescription be renewed?
For the same course of treatment, compulsory health insurance covers up to four prescriptions of nine sessions each, meaning up to 36 sessions, provided the treatment remains medically indicated.
Important: the four prescriptions are counted per course of treatment, not per calendar year. The count does not suddenly reset on 1 January.
In practice, reaching 36 sessions is relatively uncommon. Most treatments are completed well before that.
What happens after 36 sessions?
If physiotherapy needs to continue beyond 36 sessions for the same course of treatment, a simple fifth prescription is not sufficient under compulsory health insurance.
The treating doctor must send a report to the health insurer’s medical adviser. The report explains why continued treatment is medically necessary and proposes a duration or number of additional sessions.
The term long-term prescription is sometimes used informally. Legally, this is closer to a request for extended coverage, which the insurer assesses on the basis of the medical report.
This mainly concerns specific situations (for example neurological conditions, complex chronic disorders or longer rehabilitation after major surgery).
Illness or accident: why does the distinction matter?
In Switzerland, the distinction between illness and accident determines, among other things, which insurance is responsible for paying for treatment.
An illness is defined in Swiss social insurance law as an impairment of physical, mental or psychological health that is not caused by an accident and that requires medical examination or treatment, or results in incapacity for work.
An accident is legally defined as a sudden, unintentional harmful effect of an unusual external factor on the human body resulting in an impairment of health.
Typical examples of an accident
- a bicycle crash causing a shoulder injury;
- a misstep on stairs resulting in an ankle sprain;
- a collision during sport;
- a fall at work;
- a blow to the head causing a concussion.
In these situations, there is usually a clearly identifiable, sudden event affecting the body from the outside.
When is it usually not considered an accident?
Pain that develops gradually without a specific event is generally treated as illness rather than accident.
For example:
- low-back pain that increases over several weeks without a fall or impact;
- tendinopathy after a gradual increase in training load;
- symptomatic osteoarthritis;
- neck pain that develops progressively at work;
- knee pain linked to repeated overload without a clear acute event.
The distinction is not always simple. Swiss accident insurance law specifically lists certain bodily injuries, including some fractures, dislocations and injuries of the meniscus, muscles, tendons or ligaments. Whether accident insurance is responsible is assessed case by case, particularly when wear, degeneration or a pre-existing condition may have played an important role.
Who is covered by Swiss accident insurance?
Employees in Switzerland are compulsorily insured against occupational accidents. If they work at least eight hours per week for the same employer, they are also covered for non-occupational accidents, including sports, cycling and household accidents.
If they work fewer than eight hours per week for that employer, compulsory coverage does not extend in the same way to non-occupational accidents.
What difference does this make for the patient’s costs?
If an accident is recognised and covered under compulsory Swiss accident insurance (UVG/LAA), necessary treatment costs are covered without the usual health-insurance deductible or co-payment.
When treatment is covered as illness under compulsory health insurance, the annual deductible and co-payment rules apply according to the insured person’s situation.
Physiotherapy after an accident
Physiotherapy after an accident is also provided on medical prescription. Since 2025, a standardised prescription form has been used in the accident, military and disability insurance systems; Physioswiss also recommends its use in compulsory health insurance.
For treatment following an accident, it is useful to provide the physiotherapy practice with:
- the physiotherapy prescription;
- the name of the accident insurer;
- the claim or case number, if already available;
- relevant medical or surgical reports that may help guide rehabilitation.
Do you have a physiotherapy prescription?
You can view our physiotherapy services in Basel or book an appointment online.
If you are unsure whether your treatment should be billed as an accident or an illness, we can help you check which information and documents are usually required. The final decision regarding insurance coverage always remains with the responsible insurer.
Sources and legal background
- Federal Office of Public Health – non-medical services
- Physioswiss – up to four prescriptions per course of treatment
- Suva – distinction between accident and illness
- FOPH – compulsory accident insurance
- Physioswiss – physiotherapy prescription form
General information, updated for 2026. It does not replace an individual insurance decision or legal advice.
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