TARDOC 2026: Switzerland's new outpatient billing (and why Galeon is TARDOC-ready)

Since 1 January 2026, outpatient medical services in Switzerland have been billed under a new tariff system: TARDOC and outpatient lump sums replace TARMED, in place since 2004. For hospitals, clinics and their outpatient units, this is not a simple change of grid: it is a change of billing logic that puts the information system on the front line. An electronic health record that cannot code and bill under TARDOC means undervalued activity and rejected invoices.

L'essentiel en 30 secondes

What is the TARDOC reform?

TARDOC is the new fee-for-service (per-item) tariff structure for outpatient medicine in Switzerland. With around 1,400 tariff positions, versus more than 4,600 in TARMED, it aims to better reflect present-day medicine and includes a dedicated chapter for family medicine and pediatrics. It is complemented by outpatient lump sums: around 300 fixed-amount packages for more complex, standardizable treatments. Together, TARDOC and the lump sums form the global outpatient tariff that replaces TARMED, in force since 2004 and now outdated. The Federal Council approved the reform, which entered into force on 1 January 2026; inpatient services, for their part, do not change.

Two pillars: fee-for-service and lump sum

The reform rests on two complementary logics:

• TARDOC, fee-for-service: each procedure is billed individually, according to its tariff position. It is the backbone of basic outpatient care.
• Outpatient lump sums, flat rate: for complex treatments, a fixed amount covers the intervention, including medications, implants and laboratory analyses (pathology joins the scheme from 2027).

For a facility, the challenge is not only to know both grids, but to know which one applies to each episode of care, and to respect the cumulation and limitation rules specific to TARDOC.

Cost neutrality and a monitored transition

The law requires that a change of tariff model must not, in itself, generate additional costs: this is the principle of cost neutrality. To ensure it, OTMA SA (Organisation for Outpatient Medical Tariffs), backed by the FMH, H+ and the insurers (prio.swiss), puts monitoring and adjustments in place. The grid is not frozen: a first update is planned for 1 January 2027, followed by annual updates, via a tariff-evolution request procedure. In practice, the first months are a transition phase in which rejected invoices and valuation gaps must be tracked closely.

What changes in practice for facilities

• Two logics to combine: fee-for-service (TARDOC) and flat rate, with rules that determine which one applies.
• New positions and cumulation rules: TARMED coding does not transpose mechanically, habits have to be revisited.
• Annual updates from 2027: the information system must keep up without a heavy project at each revision.
• Cost-neutrality tracking: activity and its valuation must be measurable to objectify the impact.

Why your information system is on the front line

A tariff only pays if it is applied correctly at the point of care. If procedures are not structured at the source, TARDOC billing becomes manual work, a source of errors, insurer rejections and lost revenue. Conversely, an electronic health record that structures clinical data and applies the TARDOC and lump-sum rules in real time turns tariff compliance into a reflex, with no extra burden on care teams. The stakes are all the higher as hospital outpatient activity keeps growing.

Galeon is TARDOC-ready

Galeon, the AI-powered electronic health record, is built for Swiss outpatient billing:

• Structured at the source: every procedure is normalized as it is entered, ready to be valued.
• TARDOC and lump-sum rules applied live: the right tariff, fee-for-service or flat rate, is suggested in context, with cumulation rules.
• Annual updates absorbed: the revisions published by OTMA are integrated, with no rebuild at each release.
• AI-assisted coding: AI helps surface billable procedures that would otherwise be missed and reduces under-coding.
• Activity steering: valuation tracking helps objectify cost neutrality and the gaps.

For a Swiss facility, the result is fully valued outpatient activity, fewer rejected invoices, and teams that document instead of reprocessing tariffs.

How to prepare for TARDOC

1. Map your outpatient activity and the TARDOC and lump-sum positions involved.
2. Check that your EHR applies the rules (positions, cumulations, limitations) at entry, not downstream.
3. Set up tracking of rejections and valuation gaps from the first months.
4. Make sure the annual OTMA updates, from 2027, will be integrated automatically.
5. Objectify cost neutrality with activity and valuation indicators.

Key takeaways

• TARDOC and outpatient lump sums replace TARMED since 1 January 2026, for outpatient care.
• Two logics (fee-for-service and flat rate), a living grid updated every year by OTMA from 2027.
• The real risk is operational: applying tariffs poorly means undervaluing activity.
• An EHR that structures and applies the rules at the source, like Galeon, secures billing.

FAQ

Does TARDOC really replace TARMED?
Yes, for outpatient medicine, since 1 January 2026. TARMED is no longer the reference structure.

Are TARDOC and outpatient lump sums the same thing?
No. TARDOC bills per item (around 1,400 positions); outpatient lump sums (around 300) cover certain complex treatments at a flat rate. Both coexist within the global outpatient tariff.

Is inpatient care affected?
No. The reform covers outpatient care; inpatient services do not change.

Is the grid final?
No. A first update is planned for 1 January 2027, then annual updates by OTMA. An information system must be able to follow.

Will the reform increase costs?
The law requires cost neutrality: the change of model must not, in itself, generate additional costs. OTMA monitors this.

Is Galeon ready for TARDOC?
Yes. Galeon structures procedures at the source and applies the TARDOC and lump-sum rules, with annual updates integrated.

Sources

• Federal Office of Public Health (FOPH): TARDOC and outpatient lump sums
• FMH: outpatient tariffs