Key points at a glance
- Elective doctors (Wahlärzt:innen) have no contract with the health insurance funds. Patients pay the fee and get back 80 % of the insurance fund’s tariff (§ 131 ASVG) – not 80 % of your fee.
- Before you start: entry in the Ärzteliste (register of doctors), notification of your practice location within one week and professional liability insurance of at least €2 million per claim.
- Since 1 January 2026, elective doctors must also use the e-card, ELGA and the e-Impfpass; since 1 July 2026, diagnoses are coded with ICD-10.
- With patients’ consent, you submit paid invoices electronically to the insurance fund. According to the ministry, small practices with up to around 300 different patients a year are exempt.
- New patients almost always look for elective doctors online – by specialty, location, fee and reviews.
This post is general information and does not replace legal or tax advice. Rules change – check details with your chamber, your professional association or your tax adviser.
Elective doctor, contract doctor or both?
Contract doctors (Kassenärzt:innen) have a contract with the Österreichische Gesundheitskasse (ÖGK, Austrian Health Insurance Fund) and usually also with BVAEB and SVS. Patients pay nothing, and the doctor bills according to the insurance fund’s fee catalogue. Contract positions are advertised and awarded on a points system – which can take time. Elective doctors have no Kassenvertrag (insurance fund contract): they set their own fees, patients pay directly and submit the invoice for reimbursement. The general steps of setting up – premises, financing, tax – are covered in our guide to opening a practice in Austria.
| Contract practice (Kassenordination) | Elective doctor’s practice (Wahlarztordination) | |
|---|---|---|
| Fee | according to the insurance fund’s fee catalogue | set by you |
| For patients | free of charge with the e-card | pay themselves, get 80 % of the fund’s tariff back |
| Time per patient | often tight | freely planned |
| Access | advertised position, ranking by points | registration, practice location and liability insurance are enough |
| e-card and ELGA | mandatory | also mandatory since 2026 (with exceptions) |
| Patient numbers | usually high right away | have to be built up |
Many start out as elective doctors and apply for a contract position at the same time – or combine a hospital job with a small elective practice. The Ärztegesetz (Medical Practitioners Act) allows up to two Berufssitze (practice locations) in Austria (§ 45 (3) ÄrzteG). A “mobile practice” without a fixed location, on the other hand, is prohibited (§ 45 (4) ÄrzteG).
Requirements and registration
Entry in the Ärzteliste
Before you start practising, you apply for registration with the Österreichische Ärztekammer (Austrian Medical Chamber) (§ 27 ÄrzteG) – with proof of training, a medical certificate and a criminal record certificate. The certificates may be no more than three months old when you apply.
Choose and notify your practice location
You notify the Ärztekammer in writing within one week of opening, moving or closing a practice location – for a move, with the new address (§ 29 (1) ÄrzteG).
Take out professional liability insurance
You may only work on a self-employed basis once the insurance has been taken out and proven: at least €2 million per claim and at least €6 million per insurance year (§ 52d ÄrzteG).
SVS and Wohlfahrtsfonds
Under the FSVG, your practice income is covered for pension and accident insurance with the SVS (social insurance for the self-employed) – but not for health insurance. Clarify with your regional medical chamber how to arrange health cover. On top of this come contributions to the chamber’s Wohlfahrtsfonds (welfare fund).
Tax office
Register your self-employed activity with the Finanzamt (tax office). Practice income counts as income from self-employment; medical treatments are generally exempt from VAT. A tax adviser who works with doctors will save you a lot of time here.
e-card system, ELGA and software
Set up practice software with an e-card connection or e-Wahlpartner, activate ELGA and the e-Impfpass and prepare electronic invoice submission. What exactly applies is explained in the next section.
e-card, ELGA, invoices, ICD-10: what has applied since 2024
- Since 1 July 2024 – invoices: Self-employed doctors submit paid invoices electronically to the insurance fund with the patient’s consent (§ 32b (2) ASVG), for example via WAH-Online to ÖGK, BVAEB and SVS. Doctors for whom this is impossible or would require disproportionate effort are exempt; according to the Ministry of Social Affairs, the duty applies to practices with more than 300 different patients a year.
- Since 1 January 2026 – e-card, ELGA, e-Impfpass: Doctors without an insurance fund contract also use the e-card and e-card infrastructure, ELGA (Austria’s electronic health record: reading e-Befund, reading and entering e-Medikation) and the e-Impfpass (electronic vaccination record) (§ 49 (7) ÄrzteG) – in line with technical requirements that involve proportionate effort.
- Since 1 July 2026 – ICD-10 coding: After a pilot phase in the first half of 2026, elective doctors record at least one ICD-10 code for every outpatient contact involving services reimbursable under social insurance law and transmit it via the e-card service e-Wahlpartner (§ 6a (4) Dokumentationsgesetz). This duty is tied to the e-card duty under the Ärztegesetz.
Reimbursement: what patients actually get back
The insurance fund reimburses 80 % of the amount it would pay a contract doctor for the same service (§ 131 (1) ASVG). An example with round numbers: your fee for a first consultation is €120, and the fund pays contract doctors €40 for it. The patient then gets €32 back – not €96. This gap surprises many people, and it causes frustration if nobody explains it beforehand.
With electronic submission, patients often no longer have to submit the invoice themselves. Still, explain briefly on your website and at reception how reimbursement works, how long it takes and that it depends on the fund’s tariff. A worked example removes uncertainty – and saves calls to the practice.
Setting your fees and making them transparent
As an elective doctor, you set your fees yourself. Take your specialty, region, time required and the fees of colleagues nearby as a guide. Factual price information is allowed: the Ärztegesetz does not prohibit prices, only information that is unobjective, untrue or damaging to the profession’s reputation (§ 53 ÄrzteG). What this means for your website, Google and social media is covered in the post on advertising rules for doctors in Austria.
How to get it right
- State fees for the first consultation and follow-up appointments on your website
- Explain that the fund reimburses 80 % of its own tariff – with a worked example
- List payment methods (card, cash, bank transfer) and cancellation rules
Better not
- Bait offers or a “free first consultation” as an advertising promise
- Promising reimbursements the insurance fund does not guarantee
- Giving fees only over the phone
How patients find elective doctors
Patients choose elective doctors deliberately – and research beforehand. They search by specialty and location (“dermatologist Wahlärztin Graz”), read reviews and compare waiting times and fees. Three things help most:
- A website that answers questions: areas of focus, fees, reimbursement, directions, step-free access, appointments. What it should include is in 12 things patients look for on your website; the mandatory information is in the guide to legal notice and privacy in Austria.
- A well-maintained Google Business Profile with reviews: especially important for elective doctors, because patients weigh their options first. How to set up the profile is shown in the post on the Google profile for practices; a review QR code for reception makes leaving reviews easy.
- Online booking: people who are deliberately looking for an elective doctor like to book right away – including in the evening and at weekends.
What your practice could look like online
Take a look at example websites for general and specialist practices – with fees, reimbursement, live opening status and online booking.
Checklist: before your first appointment
Your elective practice, ready to go
- Entry in the Ärzteliste completed
- Practice location chosen and notified to the Ärztekammer within one week
- Professional liability insurance (at least €2 million per claim) taken out and proven
- Insurance declaration submitted to the SVS, health insurance arranged
- Self-employed activity registered with the tax office
- Practice software, e-card/e-Wahlpartner, ELGA and e-Impfpass set up – or exemption checked and patient information prepared
- Fees set and reimbursement explained with a worked example
- Website with legal notice, Google profile and online booking live
Sources
- RIS – Ärztegesetz 1998 (§§ 27, 29, 45, 49, 52d, 53)
- RIS – ÄrzteG § 49 (e-card, ELGA, e-Impfpass)
- RIS – ASVG § 131 (reimbursement of costs)
- RIS – ASVG § 32b (electronic submission of invoices)
- Sozialministerium – Elektronische Übermittlung von Wahlarztrechnungen
- Sozialministerium – Ambulante Leistungs- und Diagnosendokumentation
- Gesundheit Österreich GmbH – Ambulante Diagnosencodierung im Wahlarztbereich
- Ärztekammer für Kärnten – information for elective doctors (Gesundheitsreform 2024)
- Ärztekammer Wien – Info-Blatt FSVG-Pflichtversicherung
