Is therapy covered by health insurance in Germany?

Statutory health insurance: the usual route

With statutory health insurance, psychotherapy is covered when it is given by a psychotherapist who can bill the Krankenkasse, in one of four recognised procedures: analytic psychotherapy, depth-psychological psychotherapy, behavioural therapy or systemic therapy. According to the 116117 patient service, the steps are as follows.

1. Psychotherapeutische Sprechstunde: a first appointment to clarify whether you need treatment and which kind. It always comes first, and you do not need a referral.
2. Acute treatment (Akutbehandlung): in an urgent situation, up to 12 sessions of 50 minutes, without an application to the Krankenkasse.
3. Trial sessions (probatorische Sitzungen): to get to know each other and complete the diagnosis before a longer therapy. You also see a GP or a specialist to rule out physical causes (Konsiliarbericht). Since 30 July 2026, this report is no longer needed if the treatment follows a referral from a doctor who can bill the Krankenkasse, or a hospital’s recommendation after psychiatric, psychosomatic or psychotherapeutic treatment in hospital (BPtK, 16 October 2026).
4. Application to the Krankenkasse for short-term therapy (12 to 24 sessions) or long-term therapy (about 30 to 60 sessions, depending on the method).

Finding a place and waiting times

You can search for practices on psychotherapiesuche.116117.de, by phone on 116117 or on eterminservice.de. The search can be filtered by the languages spoken by the practice team.

After the Sprechstunde, you may receive a form (PTV 11) with a referral code (Vermittlungscode) if the treatment is marked as needed soon. With this code, the appointment service must find you an appointment within one week, no more than four weeks ahead, or two weeks ahead for acute treatment. If it cannot, it must offer you an appointment in a hospital outpatient clinic (§ 75 (1a) SGB V).

In practice, the wait for a place in therapy can be long: in an analysis of billing data, the BPtK found an average of 142 days between the first consultation and the start of treatment (patients whose first consultation took place in early 2019, published in December 2022).

Kostenerstattung: a private practice paid by your Krankenkasse

If your Krankenkasse cannot provide an urgent treatment in time, or wrongly refuses it, it must reimburse the costs of a necessary treatment you obtained yourself (§ 13 (3) SGB V). For psychotherapy, this is called Kostenerstattung: you are treated in a private practice, and if your application is approved, your Krankenkasse pays.

The law sets a condition for the therapist: the costs are only reimbursable if the psychotherapist meets the requirements of § 95c SGB V, that is a licence as a psychotherapist (Approbation) and a completed further training, or for older licences a specialist qualification (Fachkunde), in a procedure recognised for statutory insurance. Not every therapist on our platform meets these conditions: ask your therapist before you apply.

The steps recommended by the BPtK

1. Attend a psychotherapeutische Sprechstunde. If the psychotherapist has no free place, you receive a written certificate stating which treatment is recommended; it can also state that the treatment is necessary and cannot be postponed.
2. Contact several psychotherapists who can bill the Krankenkasse and keep a record of your search: name, date and time of your request, and the waiting time for a place. The BPtK mentions at least three to five refusals.
3. Find a private practice that can treat you at short notice, and ask for a written confirmation. The psychotherapist should have a specialist qualification in a recognised procedure (Fachkunde in einem Richtlinienverfahren).
4. Send your Krankenkasse an application for outpatient psychotherapy and Kostenerstattung under § 13 (3) SGB V, with the three documents: the certificate from the Sprechstunde, the record of your search and the confirmation from the private practice.

These steps come from a BPtK patient information sheet of May 2017. In 2018, the BPtK confirmed that the right to Kostenerstattung still exists and advised clarifying it with the Krankenkasse before treatment. In 2025, the Psychotherapeutenkammer Berlin noted that there are no uniform requirements that insured people must meet to obtain approval, and that requests for additional evidence often delay it.

How long the Krankenkasse has to decide

The Krankenkasse must decide within three weeks of receiving the application, or within five weeks if it asks for an expert opinion, for example from the Medical Service (Medizinischer Dienst). If it cannot meet the deadline, it must tell you in good time, in writing or electronically, and give its reasons. Without a sufficient reason, the application counts as approved once the deadline has passed (§ 13 (3a) SGB V).

What may change in 2027

The GKV-Beitragssatzstabilisierungsgesetz in principle puts psychotherapy paid by statutory health insurance back under a budget from 1 January 2027. According to the Psychotherapeutenkammer Berlin (9 September 2026), its fee rules only directly concern contract psychotherapy, not private practices, and its effects on Kostenerstattung cannot yet be fully assessed. On 15 October 2026, the Bundestag adopted exceptions, for example for children and adolescents, for some severely mentally ill patients and for acute treatment arranged through the appointment service (BPtK, 20 October 2026).

Private health insurance (PKV)

With private health insurance, you have a legal claim to the benefits agreed in your contract (PKV-Verband). The consumer advice centre (Verbraucherzentrale) explains that the scope of cover is set individually in each contract and can vary widely between tariffs. It advises private patients to ask for a cost estimate (Kostenvoranschlag) and then to contact their insurer before treatment.

• Psychotherapists and Heilpraktiker have their own fee schedules: the GOP for psychotherapists, which refers to the fee schedule for doctors (GOÄ, § 1 GOP), and the GebüH for Heilpraktiker.
• According to the PKV-Verband, many tariffs require invoices drawn up according to these fee schedules.
• Since 1 July 2024, billing recommendations for the Sprechstunde, acute treatment and short-term therapy apply. They were agreed by the German Medical Association, the BPtK, the Beihilfe offices of the federal government and of the states, and the PKV-Verband; Hamburg and Schleswig-Holstein had not yet joined in June 2024.

Beihilfe for civil servants

Federal Beihilfe only pays for psychotherapy given by the persons listed in Annex 3 of the Federal Beihilfe Regulation (BBhV): doctors and psychotherapists with specific qualifications. Heilpraktiker are not listed there. If you receive Beihilfe from a federal state, its own rules apply: ask your Beihilfe office before treatment starts.

Paying yourself

If you pay yourself, you need neither an application nor a referral, and you can choose a therapist who speaks your language, online or in person in Berlin. Among the therapists on My International Therapy, an individual session of 45 to 60 minutes costs between €50 and €110 (26 October 2026). You pay online by card and receive an invoice for each paid session.

See all price ranges and how payment works

What we do not know

• Whether your Krankenkasse will approve an application: it decides each case, and we cannot predict the result. We do not promise any reimbursement.
• What your private insurance or Beihilfe will pay: this depends on your contract and on the rules that apply to you.
• Whether a given therapist meets the conditions of your insurer: ask the therapist and your insurer.
• How the 2027 changes will affect waiting times and Kostenerstattung.

If you are in crisis or in danger, do not wait for an appointment: call 112.

Frequently asked questions

Does German health insurance cover therapy?

Statutory health insurance covers outpatient psychotherapy with psychotherapists who can bill the Krankenkasse, in four recognised procedures. Private insurance covers what your contract provides. In both cases, check with your insurer before treatment starts.

How long is the wait for therapy in Germany?

With a referral code, the 116117 appointment service must find you an appointment within one week, no more than four weeks ahead (two weeks for acute treatment). For the start of treatment, the BPtK reported an average of 142 days after the first consultation, based on data from 2019.

What is Kostenerstattung for psychotherapy?

It is the route by which your Krankenkasse pays for treatment in a private practice when no psychotherapist who can bill it can treat you in time (§ 13 (3) SGB V). The therapist must meet the conditions of § 95c SGB V, and you apply with a certificate from the Sprechstunde, a record of your search and a confirmation from the private practice.

How do I find an English-speaking therapist with statutory insurance?

The 116117 practice search lets you filter practices by the languages spoken by the practice team. If no psychotherapist who can bill the Krankenkasse can treat you in time, Kostenerstattung may be an option.

Do I need a referral for therapy?

No referral is needed for psychotherapy paid by statutory health insurance: you start with a psychotherapeutische Sprechstunde. If you pay yourself, you can book directly.

Sources

• § 13 SGB V – Kostenerstattung (gesetze-im-internet.de)
• § 75 SGB V – Inhalt und Umfang der Sicherstellung (gesetze-im-internet.de)
• § 95c SGB V – Voraussetzung für die Eintragung von Psychotherapeuten in das Arztregister (gesetze-im-internet.de)
• Psychotherapie (116117.de, patient service of the Kassenärztliche Bundesvereinigung)
• Leichte Sprache (116117.de, practice search filters)
• Psychisch Kranke warten 142 Tage auf eine Psychotherapie (BPtK, 9 December 2022)
• BPtK-Patienteninformation Kostenerstattung (BPtK, 22 May 2017, PDF)
• Weiterhin Anspruch auf Kostenerstattung in psychotherapeutischer Privatpraxis (BPtK, 6 August 2018)
• Hürden in der Kostenerstattung (Psychotherapeutenkammer Berlin, 3 June 2025)
• GKV-Beitragssatzstabilisierungsgesetz – FAQ zum aktuellen Stand und Ausblick (Psychotherapeutenkammer Berlin, 9 September 2026)
• Q&A zur psychotherapeutischen Versorgung nach Korrekturen am GKV-BStabG (BPtK, 20 October 2026)
• Kein Konsiliarbericht bei Überweisung oder nach Krankenhausbehandlung erforderlich (BPtK, 16 October 2026)
• PKV-Leistungen und Erstattung (PKV-Verband)
• Psychotherapie: Abrechnungsempfehlungen stärken Leistungen für Privatversicherte und Beihilfeberechtigte (PKV-Verband, 28 June 2024)
• Was erstattet die Krankenkasse? (Verbraucherzentrale, as of 23 January 2025)
• § 1 GOP (gesetze-im-internet.de)
• § 18 BBhV – Psychotherapeutische Behandlungs- und Anwendungsformen (gesetze-im-internet.de)
• Anlage 3 BBhV (gesetze-im-internet.de)
• Fees of the therapists on My International Therapy: our own data, 26 October 2026.

Our vision

Psychological Support for Berlin expats

My International Therapy aims at providing a reliable and patient-focused psychological support for Berlin expats