TARDOC vs. TARMED: what actually changes for your billing

The core difference: TARMED was one single-service tariff for everything; since 1 January 2026 outpatient billing is split between TARDOC single positions and Ambulante Pauschalen flat rates — with new positions, new point values and stricter, machine-checkable rules.

What actually changed

• Two systems instead of one. Standardised, well-delimited treatments are billed as flat rates; everything else via TARDOC single positions. Under TARMED, everything was single positions.
• New position catalogue. TARDOC positions are not a renaming of TARMED positions. Time values, service components and groupings were rebuilt, so familiar TARMED billing patterns do not carry over one-to-one.
• Stricter limitations. Per-session and per-side quantities, age and sex constraints and cumulation rules are defined so they can be checked automatically — by insurers as well.
• Flat rate takes precedence. If a treatment matches a flat rate, billing it as single positions is not allowed. Anaesthesia positions, for example, can already be bundled inside a surgical flat rate.

Practical consequences for billing teams

1. 1Old cheat sheets are obsolete. Position numbers and combinations memorised under TARMED no longer apply.
2. 2Rejections shift from discretion to rules. Because the rulebook is machine-readable, insurers validate systematically. Errors that slipped through under TARMED now bounce.
3. 3The flat-rate check comes first. Before coding single positions, teams must check whether the case falls under an Ambulante Pauschale.

How to keep billing fast

The safest workflow is to validate every invoice against the official tariff rules before it leaves the practice. Viali TARDOC does that automatically — it proposes positions from a plain-language description, detects services already bundled in a flat rate, and flags rule violations before submission.

Frequently asked questions

What replaced TARMED?

Since 1 January 2026, TARMED is replaced by two coordinated systems: the TARDOC single-service tariff and the Ambulante Pauschalen (outpatient flat rates).

Are TARDOC positions the same as TARMED positions with new numbers?

No. The catalogue was rebuilt with new time values, service components and rules — TARMED billing patterns do not transfer one-to-one.

When do I bill a flat rate instead of TARDOC positions?

Whenever the treatment matches a defined outpatient flat rate. The flat rate then takes precedence, and the same service must not also be billed as single positions.

Did billing get stricter with TARDOC?

Yes. Limitations and cumulation rules are defined to be machine-checkable, so insurers validate invoices systematically and reject rule violations.