Switzerland

On June 9, 2026, the Swiss Federal Office of Public Health published changes to the Healthcare Benefit Ordinance (KLV/OPre), which determines coverage of medical services in Switzerland. The nearest changes will take effect on July 1, 2026, and include the introduction of the first-trimester preeclampsia screening and adjustment of the tariffs for the highest-grossing laboratory analyses (Annex 3 KLV), changes in reimbursement conditions for medical aids via the List of Medical Aids MiGel (Annex 2 KLV), as well as the expansion of the outpatient-before-inpatient policy (Annex 1a KLV) and update of coverage decisions on the List of explicitly evaluated services (Annex 1 KLV).

The application window for changes in the Swiss Classification of Surgical Procedures (CHOP) is open from June 1 to September 14, 2026. The application window for changes in the SwissDRG system is open from June 1 to July 13, 2026. The eligible applicants in both processes are limited to system stakeholders.

On June 2, 2026, OAAT AG and the tariff partners submitted the 2027 revision of the new Swiss comprehensive outpatient reimbursement system to the Federal Council for approval. The revision further develops the new system introduced in January 2026, incorporating feedback from the annual application process and focusing on updates to outpatient flat rates and TARDOC across nuclear medicine, surgery, pathology, pediatrics, and emergency care. If approved, the revised version will take effect on January 1, 2027.

At the end of March, the entity managing the DRG system in Switzerland, SwissDRG, established several unscheduled add-on reimbursement categories (ZE) for the treatment of burns with skin substitutes (autogeneic, allogeneic, alloplastic, xenogeneic). These ZE categories are valid from January 1, 2026, until December 31, 2026, for use in specific Swiss burn centers.

In March 2026, the SwissDRG, the entity managing the DRG system in Switzerland, announced that it would be accepting applications for changes from June 1, 2026, until July 13, 2026. The results of the DRG applications made in 2026 will be reflected in the 2028 version of the SwissDRG.

The application window for changes in the Swiss Classification of Surgical Operations (CHOP) will open on June 1, 2026. Interested parties can submit applications until September 14, 2026. The announcement of the 2026 CHOP application period resumes the application process, which was cancelled for the year 2025.

From February 1 to April 30, 2026, the OAAT AG (the entity managing the new Swiss outpatient reimbursement system) is accepting applications for the modifications of the TARDOC and Outpatient flat rates. Submitted proposals will be reviewed within the annual tariff development process, validated by the OAAT Board of Directors, and subsequently submitted to the Federal Council for final approval and publication.

On December 3, 2025, the Swiss Federal Office of Public Health announced amendments to the Healthcare Benefit Ordinance, including its Annex 3 (the List of Analysis). The modifications include the creation of a new code for Dermatophytes testing by nucleic acid amplification.

On December 3, 2025, the Swiss Federal Office of Public Health announced amendments to the List of Medical Aids (Annex 2 of the Healthcare Benefit Ordinance or MiGeL), which will take effect in 2026. From July 1, 2026, the MiGeL List will include a new chapter for digital health applications. The first generic category to be registered covers a health application for Cognitive Behavioral Therapy for depression.

On December 3, 2025, the Swiss Federal Office of Public Health published updates to the Healthcare Benefit Ordinance (KLV/OPre), which determines coverage of medical services in Switzerland. The changes will take effect on January 1, 2026, and relate to prophylactic vaccinations, cost containment measures, and other matters. The updates are also implemented in KLV Annexes, including the List of explicitly evaluated services (Annex 1), the outpatient-before-inpatient mandate (Annex 1a), the List of Medical Aids (Annex 2, MiGeL), and the List of Analyses (Annex 3, AL).

On November 28, 2025, the entity managing the DRG system in Switzerland, SwissDRG, published the final (billing) version of the 2026 DRG system. In total, 19 new DRGs related to cardiovascular, ENT, gastrointestinal, neurology and neurosurgery, obstetrics and gynecology, orthopedics, and some other fields were introduced. Also, four new add-on reimbursement categories were added.

On November 5, 2025, the Swiss Federal Council approved a set of adjustments and additions to the new comprehensive outpatient tariff system, which comprises TARDOC and the outpatient flat rates. The implementation of changes before the system's launch on January 1, 2026, was requested by the tariff partners in July 2025. The adjustments primarily affect emergency services, oncology, wound care, and pathology.