Fees and coverage

I am available to patients with statutory health insurance (gesetzliche Krankenversicherung) if they have not been able to find a timely treatment place with a psychotherapist who has a statutory health insurance license (Kassenzulassung).

Due to legal regulations, and despite the high demand for psychotherapy, only a limited number of therapists are allowed to bill statutory health insurers. This often leads to an exhausting search for a therapy place and to long waiting times.

However, under § 13(3) of the German Social Code, Book V (SGB V), and in accordance with the settlement before the Federal Social Court (Bundessozialgericht, BSG) of May 21, 1997 (ref. 5 RKa 15/97), people with statutory insurance are entitled to psychotherapeutic care within a reasonable waiting time and at a reasonable distance. If the health insurer cannot offer a therapy place with a contracted therapist (Vertragsbehandler) within three months, it is obliged to cover the costs of treatment in a private practice.

The costs of psychotherapy are usually covered by private health insurers. However, the number of reimbursable therapy sessions may vary depending on the insurer or the individual plan. It is therefore advisable to ask your insurer whether your plan includes reimbursement for psychotherapeutic treatment, how many sessions are reimbursed and which formalities must be observed when starting psychotherapy.

Psychodynamic psychotherapy is billed according to the fee schedule for psychotherapists (Gebührenordnung für Psychotherapeuten, GOP).

Coverage by employers' liability insurance associations (Berufsgenossenschaften) and Beihilfe offices (the state healthcare allowance for civil servants) is usually straightforward. It is advisable to check the applicable formalities with your Beihilfe office in advance.

As with private insurance, psychodynamic treatment for those entitled to Beihilfe is billed according to the fee schedule for psychotherapists (GOP).

Psychotherapeutic treatment is possible as a self-funded service. The costs are invoiced privately and are based on the fee schedule for psychotherapists (GOP).

Psychotherapy can be applied for at the youth welfare office as assistance with upbringing (Hilfe zur Erziehung) in the context of educational services under § 27 of the Child and Youth Welfare Act – KJHG (SGB VIII), or as integration assistance (Eingliederungshilfe) under § 35a of the Child and Youth Welfare Act – KJHG (SGB VIII). In justified cases, young adults over 18 can also receive this form of support under § 41 of the Child and Youth Welfare Act – KJHG (SGB VIII).

To establish the need for therapy, a specialist service of the youth welfare office in your district must be contacted before therapy begins. Points of contact are the Child and Adolescent Psychiatric Service (KJPD), the School Psychology Service (Schulpsychologischer Dienst) or the Educational and Family Counseling Center (EFB). If one of these services confirms the need for therapy, the costs are usually covered by the youth welfare office.

Psychotherapy for adults under the Heilpraktikergesetz is provided as a self-pay service. Coverage by statutory or private health insurance cannot be guaranteed.

The costs of counseling are not covered by health insurers and are therefore paid as a self-funded service. This also applies to parent counseling and to couples and family therapy.