XML5 for Tarif 590 therapists: what applies from 2026?

XML5 is the new version of the Swiss invoice standard generalInvoice. For Tarif 590 practices it does not mean that every invoice must now be transmitted electronically. It does mean that software providers and insurers are aligning their processes with the new standard.

Status at tarif590.ch: XML5 and electronic transmission are not yet available. We are preparing tarif590.ch for XML 5.0 and will inform our customers in good time. Nothing needs to change in how you work in tarif590.ch today.

The two most important dates

CSS has accepted generalInvoice XML 5.0 since 1 January 2026. For service invoices in XML 4.5 format it names 30 June 2027 as the end of acceptance. After that date CSS no longer accepts new service invoices in version 4.5.

These dates describe data exchange with CSS. They are not a general obligation requiring every Tarif 590 practice to use eTG from a particular day.

XML5 and eTG are not the same thing

XML5 is the structured, machine-readable invoice format. It defines how invoice data is described between the systems involved.

eTG stands for electronic tiers garant. Here the reimbursement receipt is transmitted electronically to the health insurer. Under tiers garant the patient remains liable for payment to the practice. The health insurer continues to reimburse its share of the services to the insured person.

Publicly available information currently shows no general eTG obligation for Tarif 590. The electronic route depends on the software in use, the connection to the insurer and the insured person’s consent. SWICA confirms that it accepts eTG from therapists, while also pointing out that not all insurers support this route yet.

Three routes within tiers garant

The process documentation of the Forum Datenaustausch distinguishes three variants for XML 5.0:

1. Submission: the invoice is submitted through the intended XML5 process.
2. Forwarding: the insured person authorises electronic forwarding; a portal or intermediary forwards the invoice copy to the insurer.
3. Retrieval: the practice transmits the invoice to an intermediary. The insured person receives their documents, while the insurer retrieves a copy of the invoice through the portal.

Which variant is actually available is not for the practice to decide alone. Software, portal and insurer all have to support the process in question.

What stays the same for your practice?

• You continue to record treatments and tariff items in your practice software.
• Under tiers garant the patient pays the invoice to your practice.
• The health insurer checks entitlement and reimburses the covered share to the insured person.
• XML5 does not automatically change your hourly rate or your payment terms.
• Where no electronic route is available, the insured person can still submit the reimbursement receipt.

What should you do now?

You do not need to change any setting in tarif590.ch today. What does make sense:

1. Keep patient and insurance details complete and up to date.
2. Transmit health and invoice data only through an intended, secure route and with the necessary consent.
3. Watch your software provider’s announcements for when XML5, and which eTG variant, is actually supported.
4. Do not additionally submit an invoice on paper once it has reached the insurer through a confirmed electronic route.

In short

XML5 is the new technical standard. eTG is one possible electronic transmission route within tiers garant. For Tarif 590 that route is, according to the publicly documented position today, neither generally mandatory nor yet available at every insurer.

tarif590.ch does not support XML5/eTG yet. We are preparing the transition and will communicate the concrete process as soon as the feature is ready for use.

Public requirements and supported insurers can change. In a specific case, check the current information from the insurer concerned.