My invoice goes to you, and you submit it to whoever covers your costs. What applies to you depends on how you are insured.
134.06–167.58 €
Billing follows the German fee schedule for psychotherapists (GOP) in conjunction with the fee schedule for physicians (GOÄ), at 2.3 times the standard rate. For a 50-minute session that comes to 134.06 to 167.58 euros, depending on which services the session involves. How much of it is reimbursed depends on your insurance. Please check that in advance; I will tell you exactly which details you need for it.
via Kostenerstattung
Although this is a private practice, I can still treat you through Kostenerstattung (reimbursement) under § 13 (3) SGB V. If you can show that you have not found a therapy place within a reasonable time, your Krankenkasse (statutory health insurer) can cover treatment with me. It is paperwork, and it is not always approved. I prepare the documents so that your application is fully reasoned. If it is refused, the terms for self-payers apply.
167.58 €
167.58 euros per 50-minute session. No applications, no assessors, and no data is passed to an insurer.
Other services
This is a private practice; it holds no licence for contracted psychotherapeutic care under the statutory system. Direct billing to a statutory health insurer is therefore not possible. The patients treated here are self-payers, privately insured patients and people entitled to Beihilfe (the reimbursement scheme for German civil servants), as well as patients with statutory insurance via Kostenerstattung under § 13 (3) SGB V.
With private health insurance, billing follows the German fee schedule for psychotherapists (GOP). For the individual services, the GOP refers to the fee schedule for physicians (GOÄ). You receive an invoice each month and submit it to your insurer.
Most insurers cover psychotherapy, but not all to the same extent. Some cap the number of sessions, some require approval in advance. So ask your insurer in writing, before you start, what it covers.
If you are entitled to Beihilfe, psychotherapy is eligible for it, but it has to be approved before treatment begins. You apply for that prior approval to your Beihilfe office, usually after the trial sessions. I prepare the paperwork for it together with you.
Cognitive behavioural therapy (Verhaltenstherapie) is normally approved for 60 individual sessions, and in exceptional cases for a further 20. Worth knowing: short-term and acute treatment count towards those 60 sessions; they are not in addition.
The share Beihilfe does not cover is met by your private supplementary insurance. For places in the group we clarify eligibility for Beihilfe in advance, case by case, because the rules differ from one Beihilfe office to the next.
You receive an invoice without a diagnosis, no report goes to third parties, and beyond my own records no note of your treatment is created anywhere.
If you have international or employer-provided health insurance, this is usually the route that applies to you: you pay the invoice and submit it to your insurer yourself. The invoice follows the German fee schedule and is accepted by most international insurers.
Some people choose this deliberately even though they are insured. It can matter when applying for permanent civil-service status, when taking out income-protection or life insurance, or simply because you do not want your treatment on file anywhere.
It is also possible to pay for yourself at first and to switch to billing through your insurer later on. Talk to me about it and we will go through the consequences calmly.
You can be in treatment with me with statutory health insurance too, via Kostenerstattung under § 13 (3) SGB V. The thinking behind it: if your Krankenkasse (your statutory health insurer) cannot provide you with a treatment place within a reasonable time, then, where the statutory conditions are met, it has to reimburse the cost of treatment in a private practice.
It is neither quick nor automatic. But it can be done, and I know the procedure well.
You get the templates for the application from me, and we go through the documents together beforehand, in German, English or Farsi. You do not have to get through this paperwork alone, nor in a language in which the words escape you.
Call the appointment service line and ask to be given a psychotherapeutic consultation appointment. There you receive the form PTV 11, which records that treatment is necessary and indicated promptly.
Your GP confirms on a separate form, the Konsiliarbericht, that physical causes have been checked. You get the form from me, so that you do not have to go looking for it.
Ask practices that bill the statutory health insurers whether they have a place for you; three to five enquiries is usual. For each one, note the date, the practice and the waiting time you were given. This list is the heart of the application.
You submit everything together: the PTV 11, the Konsiliarbericht, the list of refusals, my cost estimate and a short covering letter. You have the templates for that from me.
Your Krankenkasse has to decide within three weeks, or within five if the Medizinischer Dienst (the insurers' medical review service) is brought in. If it does not decide within that period and gives you no reason for the delay, a so-called Genehmigungsfiktion (deemed approval) may arise under § 13 (3a) SGB V. Whether an actual entitlement follows from that has to be examined case by case.
If you are unsure what applies in your case, write and tell me how you are insured. I will get back to you within two working days.
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