Psychotherapy via alternative practitioners: What Beihilfe really covers and what it doesn’t
20.05.25
12
Minutes
Katrin Straub
Managing Director at nextsure
Do you need psychotherapeutic support and are you wondering whether your civil service healthcare allowance covers the costs of treatment with a practitioner of psychotherapy? Many people entitled to civil service healthcare allowance face this uncertainty. This article explains which services are actually eligible for reimbursement and how you can take the right steps.
The topic in brief and concise terms
Psychotherapy provided by non-medical practitioners specialising in psychotherapy is generally not eligible for reimbursement; the reimbursement scheme only recognises licensed medical or psychological psychotherapists, as well as child and adolescent psychotherapists.
For psychotherapy to be eligible for reimbursement, an application with an expert assessment procedure is usually required, although up to five introductory sessions are often possible in advance without approval.
Only scientifically recognised treatments such as behavioural therapy or psychodynamic psychotherapy are covered by Beihilfe, subject to maximum rates and limits on the number of sessions.
Subsidy for psychotherapy by alternative practitioners: understanding the facts
Medical assistance only covers the costs of psychotherapy under certain conditions. Services provided by non-medical practitioners for psychotherapy are generally not eligible for cover under medical assistance. This is an important first point for many of the more than three million people entitled to medical assistance in Germany. The Federal Medical Assistance Ordinance (BBhV) explicitly excludes non-medical practitioners of psychotherapy from reimbursement of benefits. It is therefore essential to check the exact rules of your medical assistance office. Only then can you ensure which of the many therapy options are suitable for you. The following sections explain who is entitled to benefits instead.
Secure eligibility: These therapists are recognised by the Beihilfe
For psychotherapy that is eligible for reimbursement, the practitioner must demonstrate specific qualifications. Recognised are licensed medical psychotherapists and psychological psychotherapists. Child and adolescent psychotherapists with the შესაბამის? Wait German must translate. Need full English. Let's draft carefully. Also preserve strong. Registration in the medical or psychotherapists’ register is often a decisive criterion. For example, therapists must demonstrate specialist expertise in one of the three recognised treatment methods. Without this formal recognition, reimbursement by the civil service aid scheme for psychotherapeutic services is excluded. A private health insurance policy can provide additional cover here. The exact requirements for qualifications are laid down in detail in the civil service aid regulations of the federal and state governments. This ensures that only treatments by therapists with at least one of the three recognised orientations are reimbursed.
Use recognised methods: Which types of therapy are covered by Beihilfe
The subsidy does not cover the costs of every psychotherapeutic method. Only scientifically recognised methods are eligible for reimbursement. These usually include three main approaches:
Psychodynamic psychotherapy
Analytical psychotherapy
Behavioural therapy
Systemic therapy can also be eligible for reimbursement under certain conditions. However, methods such as family therapy or Rogerian talk therapy are often not eligible for reimbursement if they are not carried out within the framework of a recognised guidelines-based procedure. It is important to clarify this with the therapist and the reimbursement office before starting therapy to avoid financial surprises. The exact list of recognised and excluded methods can be found in the annexes to the respective reimbursement regulations, for example the BBhV. A supplementary health insurance policy can fill gaps here. The reimbursement rules specify particular regulations on the number of sessions for the recognised methods. For example, up to 80 sessions over two years are often possible for behavioural therapy.
Mastering the application process: step by step to cost coverage
The process of securing reimbursement for psychotherapy through the civil service benefits scheme requires several steps. Initially, assessment sessions are possible, usually up to five sessions (up to eight in the case of analytical psychotherapy). These are used for diagnosis and treatment planning and are also eligible for reimbursement without prior approval. If the therapy is to be continued, a formal application must be submitted to the benefits office. This usually includes a report from the therapist and often an expert assessment procedure. The expert report assesses the necessity, type and scope of the planned therapy. The benefits office then decides on approval and the number of sessions authorised. For acute treatment or short-term therapy (e.g. up to 24 sessions), the procedure may be simplified and carried out without a prior expert report. It is advisable to find out early from your benefits office about the exact forms and deadlines. Processing an application can take several weeks. Taking out private health insurance despite psychotherapy may be possible under certain circumstances. Early clarification of all formalities, such as obtaining a consultative report from a doctor, is essential for a smooth process.
Keeping costs in view: know the maximum reimbursable rates and number of sessions
The aid scheme does not reimburse the costs of psychotherapy without limit. Maximum rates and a maximum number of sessions per case of illness apply. The appropriateness of the expenses is based on the scale of fees for doctors (GOÄ) or the scale of fees for psychotherapists (GOP). As a rule, reimbursement is made up to 2.3 times the GOÄ rate. The number of reimbursable sessions varies depending on the type and duration of therapy (short-term or long-term therapy). For example, for behavioural therapy in long-term therapy, up to 80 sessions may be approved. For acute treatment, up to 24 sessions of 25 minutes each may be eligible for reimbursement, with a maximum amount of, for example, 51 euros per session. If the therapist’s fees exceed these rates, you must pay the difference yourself. A supplementary insurance for alternative practitioners usually does not cover these specific psychotherapy costs for treatment by alternative practitioners if the basic service is not eligible for reimbursement. It is important to check the therapist’s invoice carefully and ensure that all details are correct in order to avoid delays in reimbursement. The aid regulations also specify how often therapy may be extended; in many cases, applications and supporting reasons are required again.
Understanding the distinction: General naturopathic practitioner services versus psychotherapy
While psychotherapy under a naturopathic practitioner is generally excluded from reimbursement under the civil service aid scheme, other naturopathic treatments may, depending on the circumstances, be eligible for reimbursement. However, this does not apply to psychotherapeutic treatment provided by naturopaths for psychotherapy. For general naturopathic treatments that are not psychotherapeutic in nature, separate rules apply. These must be scientifically recognised and must not exceed certain maximum amounts. Reimbursement is often based on the schedule of fees for naturopaths (GebüH), with reasonableness assessed against comparable medical services under GOÄ. It is important to maintain a strict distinction: psychotherapeutic services provided by naturopaths are almost always excluded from reimbursement under the civil service aid scheme. Some federal states have generally restricted reimbursement of naturopathic treatments significantly or even abolished it altogether. You should therefore always clarify in advance with your Beihilfestelle which specific naturopathic treatments are covered and to what extent. A naturopathic supplementary insurance can be an option to cover costs for alternative healing methods that do not fall under the civil service aid scheme. The civil service aid regulations often contain lists of explicitly excluded methods, which makes case-by-case review essential.
Subsidy law is complex and subject to changes through new regulations or court rulings. What applies today may change in a few years. The federal subsidy regulations (BBhV) and those of the individual federal states (e.g. SächsBhVO) are the relevant legal foundations. It is therefore essential to stay informed about the current situation at all times. Your responsible subsidy office is the first point of contact for this. Professional associations or specialised advice centres can also provide current information on rulings concerning psychotherapy and subsidy coverage for alternative practitioners. For example, adjustments were made to the subsidy regulations to align them with the Psychotherapists Act, which clarified the qualification requirements. This dynamic requires continuous attention in order to avoid disadvantages in reimbursement. An outpatient supplementary insurance for treatment by alternative practitioners may be worthwhile in order to respond more flexibly to changes. Please note that different regulations with specific assessment rates may apply in some cases to civil service trainees or pension recipients. It is therefore always necessary to review the individual situation.
Secure support: your next step to optimal protection
Dealing with the details of psychotherapy, Heilpraktiker and Beihilfe can be challenging. It becomes clear that cover for psychotherapy with a Heilpraktiker via Beihilfe is not generally provided in the vast majority of cases. Instead, clearly defined qualifications of the therapist and recognised methods are necessary. To ensure that you receive the benefits you are entitled to and close any potential gaps in cover, individual advice is often the best route. With over ten years of experience in insurance, we are happy to help. We support you in analysing your insurance situation and finding suitable solutions. This can also include occupational disability insurance following psychotherapy. Use our expertise for your peace of mind. Request an individual risk analysis now: have your insurance situation reviewed free of charge and receive specific recommendations for improvement.
More useful links
LBV Baden-Württemberg offers a document (presumably a PDF) with relevant information on allowances.
LBV Baden-Württemberg provides further information on the topic of alternative practitioners.
Arnsberg District Government offers an information sheet (PDF) with detailed information on allowances for outpatient medical and alternative practitioner treatments.
VBBA provides an information sheet (PDF) on allowances for alternative practitioner services, which may be particularly relevant for senior citizens.
FAQ
What psychotherapy costs are covered by the Beihilfe?
The supplementary benefits scheme covers costs for recognised psychotherapeutic treatments carried out by qualified therapists (doctors, psychological psychotherapists). Maximum rates apply in accordance with GOÄ/GOP (usually 2.3 times the standard rate), and the number of sessions is limited. Psychotherapy by alternative practitioners is generally not covered.
Are the regulations for benefits for psychotherapy consistent nationwide?
The Federal Subsidy Ordinance (BBhV) forms the basis for federal civil servants. The federal states have their own subsidy ordinances, but these often follow the BBhV. However, there may be differences in detail, so it is important to check the currently applicable state ordinance.
What happens if my therapist charges higher rates than the subsidy?
If the therapist charges higher fees than the maximum rates eligible for reimbursement (e.g. above the 2.3 times GOÄ rate), you must bear the difference as your own contribution. It is advisable to clarify the costs with the therapist in advance.
Does my private health insurance cover the shortfall in Beihilfe for psychotherapy?
This depends on your individual tariff with private health insurance. Many plans for people entitled to Beihilfe supplement the Beihilfe benefits. Check your policy terms or ask your private health insurer, especially regarding reimbursement for psychotherapy and any remaining costs.
Can I take out supplementary insurance for psychotherapy with alternative practitioners?
There are supplementary insurance policies for alternative practitioners that cover certain alternative treatment methods. However, whether these explicitly include psychotherapy provided by practitioners for psychotherapy, and to what extent, must be checked carefully, as this is often excluded if the allowance does not pay.
Where can I find the forms for applying for psychotherapy under Beihilfe?
You can obtain the necessary forms (e.g. application for recognition of eligibility for reimbursement of psychotherapy costs) directly from your responsible benefits office. They are often also available for download on the websites of the relevant state offices or the Federal Office of Administration.
