Ambulant vs Stationary

The core distinction

Swiss healthcare divides treatment into two fundamental categories with different billing rules:

• Ambulant (outpatient): You receive treatment and go home the same day. This includes all GP and specialist consultations, outpatient procedures and surgery, physiotherapy, dental appointments, emergency department visits where you are not admitted, and day-case treatments (chemotherapy, dialysis, etc.).
• Stationary (inpatient): You are admitted to a hospital and stay overnight, or for multiple days. This includes all hospital stays regardless of length.

The same medical procedure can be ambulant or stationary depending on how it is delivered. Cataract surgery, for example, is now routinely done as a day case (ambulant). Certain orthopaedic operations can go either way depending on complexity and recovery needs.

Why the distinction matters for billing

Ambulant and stationary care are billed using completely different frameworks:

• Ambulant: Billed using Tarmed/Tardoc codes. You receive an itemised invoice showing each service. Subject to franchise and Selbstbehalt. The insurer pays the remainder. No daily hospital contribution.
• Stationary: Billed using SwissDRG (Diagnosis Related Groups) — a flat-rate system based on the diagnosis and complexity of the case, not on individual services. The flat rate covers most costs of the stay. Subject to the CHF 15 per day Spitalbeitrag. Also subject to your franchise and 10% Selbstbehalt.

SwissDRG means that a hospital stay for a specific procedure costs roughly the same amount regardless of how many tests or interventions happen during the stay — the DRG code determines the payment. This incentivises hospitals to be efficient.

The trend toward ambulant treatment

Swiss health policy has been actively pushing more procedures from inpatient to outpatient. As of 2022, a list of specific procedures are designated as ambulant by default — if a hospital wants to provide these as inpatient treatment, they must justify it medically, and the insurer may not cover the inpatient rate if outpatient was clinically appropriate.

This list includes procedures such as:

• Laparoscopic cholecystectomy (gallbladder removal)
• Inguinal hernia repair
• Cataract surgery
• Knee arthroscopy
• Tonsillectomy
• Varicose vein surgery

If you are offered an overnight stay for one of these procedures and prefer to go home the same day, discuss this with your surgeon. If you genuinely need overnight care (due to complications, recovery difficulty, or social circumstances), document this so the hospital can justify the inpatient classification to your insurer.

Hybrid cases: day-hospital (tagesklinisch)

Some treatments fall between true outpatient and inpatient care: day-hospital stays (Tagesklinik, hôpital de jour). You arrive in the morning, receive treatment, and leave in the evening — no overnight stay, but the intensity of care is higher than a typical outpatient visit.

Day-hospital treatment is billed ambulantly under Tarmed/Tardoc, not under SwissDRG. The CHF 15/day Spitalbeitrag does not apply. This classification is generally more favourable for patients.

Cross-cantonal hospital stays

If you are treated as an inpatient in a hospital outside your home canton (i.e., you cross a cantonal border for planned treatment), billing becomes more complex:

• KVG covers the rate that your home canton would pay for the same DRG treatment in a home-canton hospital
• If the out-of-canton hospital charges more than this rate, the difference may fall on you
• Exception: if the treatment was not available in your home canton or was referred by a specialist

For emergency inpatient stays outside your canton, KVG coverage applies without restriction. For planned cross-cantonal treatment, confirm coverage with your insurer before admission.