How much would you pay for therapy

COST ASSUMPTION

A private practice can settle accounts with all private health insurances, the allowance and also with the professional associations. There are special regulations for members of the Bundeswehr and Federal Police, according to which they can also be treated directly in a private practice. There are similar conditions for civil servants of the Federal Railways and the Post. In addition, you are of course always free to pay the costs of psychotherapy privately as a self-payer.

Are you legally insured? Although I run a private practice, I often receive inquiries from legally insured fellow citizens who are desperately looking for a free therapy place. In the hope of being able to be at least a little helpful, I have presented the current situation and the possibilities of those with statutory health insurance in particular at the end of this page.

In the following you will find detailed information on the respective insurance providers. I would be happy to support you with the regulations in individual cases.


Private health insurance

Private health insurance companies usually cover the costs of psychotherapy and the costs are usually reimbursed without any problems. However, different insurance companies handle this in different ways. Your exact conditions as a private patient can be found in your insurance contract or you can ask your insurance company directly. Please note the following points:

Psychotherapy in private practice: checklist for private patients

  • Is psychotherapy included in the scope of the contract?
  • If so, how many therapy hours are planned?
  • Will the insurance reimburse the costs in full or only partially?
  • Which documents are required for the application?

Please clarify your individual contract modalities before starting therapy. If you have any questions, I will be happy to help you.

The basis for billing my services for private patients is the fee schedule for psychological psychotherapists (GOP). On the website of the Federal Chamber of Psychotherapists you can see a list of all relevant GOP digits.

General information on the subject of "Psychotherapy: Which treatments does private health insurance take over?" Can be found on the pages of the service portal derprivatpatient.de, for example.

 

Aid

As a rule, the grant offices cover the costs of psychotherapy after the application has been properly submitted. Please inform yourself in good time at your subsidy office about the individual conditions for the assumption of costs. You can obtain the relevant documents from your aid office.

Those entitled to federal aid can find all the important information and forms for submitting applications on the website of the Federal Office of Administration. State officials from North Rhine-Westphalia can find a letter to send the application for prior recognition of outpatient psychotherapy on the website of the district government of Düsseldorf. For municipal officials from the Rhineland, there is an informative video explaining how to apply, as well as further information on the website of the Rhenish pension fund.

 

Professional associations

Employers' liability insurance associations usually reimburse the costs for psychotherapy if this becomes necessary for work-related circumstances. In such a case, please contact your professional association in good time and arrange for the relevant application forms to be sent.

 

Medical care of the Bundeswehr

Soldiers can take advantage of psychotherapy in a private practice based on an agreement between the Federal Chamber of Psychotherapists (BPtK) and the Federal Ministry of Defense. Details on this agreement can be found on the BPtK website under the heading “Treatment of soldiers in private practices”.

For an initial consultation, it is only necessary to present a cost assumption declaration issued by the troop doctor (medical form San / Bw / 0218). On this basis, five trial sessions can initially be carried out and billed. If a subsequent psychotherapy is desired, the referring troop doctor will be informed in writing of the diagnosis, indication and therapy goal. On this basis, a treatment card is issued for 25 hours. If treatment is to take place longer than 25 hours, this must be communicated to the troop doctor at the latest after the 20th hour. A separate and detailed application is then required for such an extension. The billing takes place directly with the Federal Office for Personnel Management of the Bundeswehr, Section PA3 Heilfürsorgabrechnung in Strausberg, so that you do not have to pay in advance yourself.

 

Medical care of the federal police

Since May 2018, federal police officers have been able to contact a private practice directly and are therefore no longer dependent on the tedious search for a free treatment place in a cash practice. To this end, the Federal Chamber of Psychotherapists (BPtK) has concluded an agreement with the Federal Ministry of the Interior. Details on this agreement can be found under the title “Federal police officers can fall back on private practices” on the BPtK website.

The procedure, the applications and the approval steps are analogous to those of the statutory health insurance. It is therefore intended that a psychotherapeutic consultation is carried out before the actual psychotherapy. These consultation hours can be held with registered psychotherapists or with private psychotherapists. In the latter case, a form for documenting the consultation hour as well as further information for private therapists are stored at the BPtK. The Federal Police Headquarters, Department 83, Heilfürsorgeangelektiven (or clearing office), in 53754 Sankt Augustin, is responsible for applications and accounts. This office can be used for direct billing so that you do not have to pay in advance.

 

Health care for federal railway officials

Members of the health care of the Federal Railroad Officials (KVB) have the option of receiving treatment from a licensed psychological psychotherapist in a private practice.

 

Post Office Health Insurance Fund

People who belong to member group B of the Postbeamtenkrankenkasse (PBeaKK) can seek treatment from a licensed psychological psychotherapist in a private practice. Relevant information on psychotherapy and an information sheet on psychotherapeutic treatment are available on the PBeaKK website.

 

Self-payers

Of course, there is always the option of paying for psychotherapy yourself. In this case, there is a treatment contract between the client and the therapist and all further formalities are omitted. The fee is based on the fee schedule for psychological psychotherapists (GOP), which is closely based on the fee schedule for doctors (GOÄ). The costs for a regular 50-minute behavior therapy session are exactly € 100.55 according to GOP number 870 with the usual 2.3-fold increase rate. The GOP and the fees set in it have not been adjusted / increased since 2001.

Psychotherapy as a self-payer? These are the advantages:

  • Quick help || Psychotherapy or counseling / acute help can be started straight away.
  • Freedom of choice || The selection of a suitable therapist is of course possible.
  • Full control || The type and duration of therapy can be determined by yourself. As long as you want, no longer than necessary.
  • Comprehensive discretion and independence || No insurance company or any other authority finds out anything / interferes. (*)
  • No blocking period || The usual 2-year blocking period for statutory health insurance patients after completion of / discontinued therapy does not apply.
  • focus on the essentials || There is no need for any bureaucracy in the form of applications, forms or reports.
  • Flexible scheduling || Private practices often also offer evening appointments or even Saturday appointments.
  • continuity || Many clients appreciate being able to come back at short notice at any time in the future if necessary.

(*) Info for younger interested parties: Can I block my future through psychotherapy? SPIEGEL from June 2nd, 2020
(*) Possibly also worth reading: And then you have an F-number Frankfurter Allgemeine Zeitung from 07.12.2014

 

Statutory health insurance

Updated in April 2021

Preliminary remark:
As a legally insured person, I would be happy to offer you a solution that is just as simple as in the cases listed above. Unfortunately, access to private practices for those with statutory health insurance has become increasingly difficult lately, which I expressly regret.

Psychotherapy is one of the standard benefits of statutory health insurance and the costs are fully covered if indicated. It should be noted that statutory health insurances usually only cover the costs of psychotherapy for therapists with a health insurance license, but not for treatment in a private practice.

Due to the dramatic supply bottlenecks for health insurance therapists, which in the past led to unreasonably long waiting times for those with statutory health insurance, a new psychotherapy guideline came into force on April 1, 2017. Within the framework of this guideline, telephone availability, practice consultation hours and acute therapies have been added to the contractual psychotherapeutic offer. It is intended that legally insured persons make use of this offer and contact a health insurance provider in their area.

Unfortunately, finding suitable therapists using a Google search is not always easy, since many health insurance-approved therapists are neither represented on the common search portals nor have their own homepage to present themselves and their treatment methods. Therefore, here are a few tips for finding a psychotherapist:

This is how you can find all psychotherapists with health insurance approval in your area:

You can find all health insurance providers based in the Cologne area with the help of the Practice search of the North Rhine Association of Statutory Health Insurance Physicians (KVNO)by entering your postcode and making a selection below under the heading "Psychotherapy procedures", e.g. "Psychotherapy for adults" or directly "Behavioral therapy for adults".

If you do not live in the catchment area of ​​the KVNO, you can also contact the health insurance providers in question throughout Germany via the Doctor search of the National Association of Statutory Health Insurance Physicians (KBV) Find. Here, too, the postcode and the subject area must be entered. For the latter, you have to go to the "Psychotherapist" category and select, for example, "Psychological psychotherapist".

Some of the registered psychotherapists - by far not all - can be found on the search portal therapie.de. Advantageously, portrait photos and mostly detailed additional information are displayed here. In order to filter out only the therapists with health insurance approval, you have to select the link "GKV: health insurance approval" on the left under "Billing" on the results page.

From countless feedback from statutory health insurance patients, I know that the current psychotherapy guideline has unfortunately hardly led to an easing of the supply situation. It is not uncommon for no one to be reached by phone and there is no callback. This is due to the fact that the previously overburdened cash register therapists now also have to provide the above-mentioned services of the current guideline, i.e. that the offer has been expanded on paper, but without sufficiently increasing the limited therapy capacities. The current guideline therefore also provides for the use of a call center (appointment service point, TSS), which is intended to help you find a consultation or even a therapy place (that is not the same!) A flow chart with the nationwide telephone number of the appointment service point can be found on the website of the North Rhine Association of Statutory Health Insurance Physicians. As an alternative to contacting us by phone, you can also use the web portal of the appointment service point. You can get a very good overview of the current possibilities for cash patients on the website of Stiftung Warentest. Further information, not only about the costs, can be found on the website Paths to Psychotherapy of the Federal Chamber of Psychotherapists (BPtK). In the event that you want to get a detailed insight into the current regulations, I also link the practice information of the Federal Chamber of Psychotherapists to the current psychotherapy guidelines.

Reimbursement of costs for psychotherapy 2021? This is the current situation:

Because of the unreasonably long waiting times and the severely restricted freedom of choice, in the past many people with statutory health insurance applied for treatment in a private practice and also got it approved. Prior to April 1, 2017, it was possible to quickly treat those with statutory health insurance at identical costs and conditions through invoicing using the so-called reimbursement procedure, even in private practices. In this way, patients with statutory health insurance could quickly and easily get the help they needed in urgent cases. Regrettably, applications for reimbursement of costs are now almost consistently rejected by the statutory health insurances with reference to the psychotherapy guideline. Accurate descriptions of the resulting circumstances, conditions and grievances to which many statutory health insurance patients - and also psychotherapists - are currently exposed with the knowledge and assistance of politics, can be found in abundance in the press, e.g .:

Patients are caught in a loop: SPIEGEL article from February 11, 2018
The wait is endless: SPIEGEL article from April 11, 2018
The long wait for a therapist: Süddeutsche Zeitung from 08.09.2018
Reimbursement of costs for outpatient psychotherapy in private practices: Deutsches Ärzteblatt PP 11/2018
There is a lack of therapy places for the mentally ill: Süddeutsche Zeitung from December 11, 2018
The sometimes rocky road to psychotherapy: ZEIT ONLINE from June 16, 2020
"But I need someone now": chargeable SPIEGEL article from 07/07/2020
Trouble for aspiring psychotherapists: Deutschlandfunk Kultur from February 8th, 2021
Corona pandemic: Demand for psychotherapy has increased: aerzteblatt.de from February 12, 2021
Psyche in Need: The long wait for therapy: ZDFzoom VIDEO (28 minutes) from April 7th, 2021

Despite information to the contrary sometimes and considerable practical difficulties, the entitlement to reimbursement of costs will continue to exist even after April 1, 2017, at least in principle. At this point I am linking to a message from the Federal Chamber of Psychotherapists (BPtK). Comprehensive and up-to-date information about the reimbursement procedure, which has unfortunately become very time-consuming, can be found on the reimbursement page of therapie.de.

Conclusion: The path to reimbursement is often tedious and not necessarily promising at the present time. After April 1, 2017, I succeeded in some cases in “pushing through” a cost reimbursement procedure together with clients with statutory health insurance. Whether this succeeds depends, among other things, on which health insurance company you are dealing with. I have had good experiences with various company health insurance funds (BKKen), for example. Unfortunately, most of the larger health insurance companies are consistently negative when it comes to reimbursement. If you are considering such an attempt, I therefore recommend that you contact me beforehand. If the reimbursement of costs is not possible, the only safe alternative to waiting for a regular checkout is to pay yourself. Some of my clients have chosen this path for a long time anyway. In the event that this option is an option for you, I refer you to the Self-Pay section earlier on this page.