TARDOC, service caps and the proposed AL upper limit

Established facts

First, the tariff structures: TARDOC and the outpatient flat rates were approved by the Federal Council as new outpatient tariff structures; the responsible federal bodies and tariff partners publish the current state of implementation.

Second, cost neutrality: the introduction is subject to cost-neutrality requirements and accompanying monitoring by the tariff partners. These requirements steer cost growth during the introduction phase and are not the same as an upper limit on the physician service component.

Third, the upper limit on the physician service component: two levels must be kept strictly apart. Parliament adopted the legal basis for such an upper limit. The tariff partners’ implementation concept was submitted as part of tariff version 2027 and is not approved today; it is not an approved part of the TARDOC in force.

The figure 1’577 comes from this submitted, not-yet-approved implementation concept and is neither a tariff point value nor an amount of remuneration: if approved, a monthly average of at most 1’577 AL tariff points (TP AL) per effective working day would apply from 1 January 2027. The infrastructure and personnel service component (IPL) is not part of the upper limit. How overruns would be handled is not conclusively regulated in public (status: FMH information of 27 July 2026).

Our position

Remuneration is appropriate only when it reflects the actual effort a service requires — including time for history taking, coordination and documentation. Freie Ärzte Schweiz rejects an AL upper limit of 1’577 TP AL per effective working day: it acts as a volume and budget cap and endangers care, because medically necessary services are effectively devalued.

A blanket cap applies regardless of whether a service was medically necessary. We consider that the wrong steering approach: yes to cost responsibility, but through quality, indication and transparency — not through a volume-independent reduction.

What we ask for

First: a transparent, verifiable derivation of every capping mechanism. Second: monitoring of its effects on care, especially in primary care and rural regions. Third: involvement of practising physicians in developing the tariff structure.

Freie Ärzte Schweiz is currently not recognised as an outpatient tariff partner and is not part of OAAT. We state our position publicly and verifiably, and work to be heard as a voice of practising physicians.