Statutory health insurance
Our practice does not hold a statutory health insurance contract, so we generally cannot bill statutory insurers directly for outpatient psychotherapy. Under certain conditions, treatment may nevertheless be possible through a reimbursement procedure (Kostenerstattungsverfahren).
The application can involve considerable paperwork and requires patience and preparation. Please complete the checklist before arranging your first appointment with us, to avoid unnecessary costs. Call us if you have questions.
Download the reimbursement checklist (PDF, German)
Guide to reimbursement
1. Contact contracted practices
Contact as many local psychotherapists contracted with statutory health insurers as possible and ask when treatment can begin. Ask specifically about the start of treatment: an initial consultation, advice appointment or first meeting does not count as the start of treatment. If treatment can begin promptly, we recommend accepting that appointment.
Document at least five contacts: date, time, practice name, address and telephone number, the earliest available treatment date, waiting time and any other relevant information.
2. Arrange a psychotherapy consultation
Call the appointment service of the Association of Statutory Health Insurance Physicians on 116117 and ask for a psychotherapy consultation with a contracted psychotherapist.
Record the date and time of the call, the name of the person you spoke to, the appointment offered and the practice.
3. Attend the consultation and obtain PTV 11
Attend the consultation. The therapist will ask about your concerns, make a preliminary diagnosis and explain whether and when they can offer treatment. Ask for the form “Individuelle Patienteninformation zur ambulanten Psychotherapeutischen Sprechstunde – PTV 11”.
For the reimbursement application described by our practice, the form should state that outpatient behavioural therapy is needed, treatment cannot be provided at that practice, a timely start is necessary, and an urgency code has been issued.
4. Ask for initial assessment sessions
Call 116117 again, explain that you have already attended a psychotherapy consultation, give your urgency code and request a timely appointment for initial assessment sessions (probatorische Sitzungen) with a contracted therapist. Record the call and the appointment offered.
Three outcomes are possible: A – The service cannot offer an appointment within four weeks; continue with step 6. B – You receive an appointment with another therapist: attend it and explain that you have already had a consultation. If timely treatment is offered there, reimbursement for treatment at our practice is neither needed nor possible through this route. C – The therapist cannot offer timely treatment: obtain written confirmation.
5. Request another therapist contact
Call 116117 again and explain that you have attended both a psychotherapy consultation and an initial assessment session, but neither therapist can offer a timely therapy place. Ask for another therapist contact.
Record the date, time, person you spoke to, appointment offered and practice.
6. Document the result of the further contact
Follow the procedure in step 5. If this third psychotherapy contact also cannot offer a timely start, obtain written confirmation again.
7. Arrange an initial appointment with us
Arrange an initial appointment at our practice and bring the complete documents: records of contacts with at least five psychotherapists; your PTV 11 form; records of calls to the appointment service; and written confirmations from the therapists that timely treatment is unavailable.
We will then apply to your health insurer for reimbursement together with you.