Psychotherapy through alternative practitioners: What the health insurance really covers and what it doesn't
20 May 2025
4
Minutes
Katrin Straub
CEO at nextsure
Do you need psychotherapeutic support and are wondering if your aid covers the costs for treatment by a psychotherapist? Many eligible for aid face this uncertainty. This article clarifies which services are genuinely eligible for aid and how to take the right steps.
The topic in brief and concise terms
Psychotherapy by alternative practitioners for psychotherapy is generally not eligible for reimbursement; only licensed medical or psychological psychotherapists, as well as child and adolescent psychotherapists, are recognised for reimbursement.
For psychotherapy funding eligibility, an application with an expert review process is usually required, although up to five trial sessions are often possible in advance without approval.
Only scientifically recognized methods such as behavioral therapy or psychodynamically founded psychotherapy are covered by the aid, with maximum rates and session numbers applying.
Assistance for psychotherapy by alternative practitioners: Understanding the facts
The aid only covers costs for psychotherapy under certain conditions. Services from alternative practitioners for psychotherapy are generally not eligible for aid. This is an important first point for many of the over three million people eligible for aid in Germany. The Federal Aid Regulation (BBhV) explicitly excludes alternative practitioners for psychotherapy from reimbursement. It is therefore crucial to review the exact regulations of your aid office. Only by doing so can you ensure which of the many therapy options are available to you. The following sections explain who is entitled to benefits instead.
Ensure eligibility: These therapists are recognized by the health aid program
For eligible psychotherapeutic treatment, the therapist must demonstrate specific qualifications. Recognised are licensed medical psychotherapists and psychological psychotherapists. Child and adolescent psychotherapists with the appropriate license also belong to this group. The qualification is based on the guidelines of the Psychotherapists Act and the regulations for statutory health insurance (SGB V). Registration in the doctor or psychotherapist register is often a crucial criterion. For example, therapists must prove expertise in one of the three guideline procedures. Without this formal recognition, reimbursement by the assistance for psychotherapeutic services is excluded. A private health insurance can offer supplementary protection here. The exact qualification requirements are detailed in the aid regulations of the federal and state governments. This ensures that only treatments by therapists with at least one of three recognised specialisations are reimbursed.
Using Recognised Procedures: Which Therapy Forms are Covered by Assistance
The aid does not cover the costs for every psychotherapeutic method. Only scientifically recognized procedures are eligible for aid. These generally include three main directions:
Depth psychology-based psychotherapy
Analytical psychotherapy
Behavioural therapy
Systemic therapy can also be eligible for aid under certain conditions. Procedures like family therapy or Rogerian talk therapy often are not eligible unless conducted as part of a guideline procedure. It is important to clarify this with the therapist and the aid office before starting therapy to avoid financial surprises. The exact list of recognized and excluded procedures can be found in the annexes of the respective aid regulations, such as the BBhV. An additional health insurance can fill gaps here. The aid regulations provide specific rules for the number of sessions for recognized procedures. For example, it is often possible to have up to 80 sessions of behavioural therapy over the course of two years.
Master the application process: Step by step to cost coverage
The process for obtaining cost coverage for psychotherapy through aid requires several steps. Initially, probational sessions are possible, usually up to five sessions (up to eight for analytical psychotherapy). These serve for diagnostics and therapy planning and are eligible for aid without prior approval. If the therapy is to be continued, a formal application to the aid office is necessary. This typically includes a report from the therapist and often an expert review process. The assessment evaluates the necessity, type, and scope of the planned therapy. The aid office then decides on the recognition and the number of approved sessions. For acute treatments or short-term therapies (e.g., up to 24 sessions), the process may be simplified and proceed without prior assessment. It is advisable to check with your aid office early on regarding the exact forms and deadlines. The processing time for an application can take several weeks. Taking out a private health insurance despite psychotherapy may be possible. Early clarification of all formalities, such as obtaining a consular report from a doctor, is essential for a smooth process.
Keeping an Eye on Costs: Knowing the Maximum Allowable Rates and Number of Sessions
The allowance does not reimburse the cost of psychotherapy without limits. There are maximum rates and a maximum number of sessions per illness. The appropriateness of expenses is determined by the fee schedule for doctors (GOÄ) or the fee schedule for psychotherapists (GOP). Usually, reimbursement is up to 2.3 times the rate of the GOÄ. The number of eligible sessions varies depending on the form and duration of therapy (short-term or long-term therapy). For example, in long-term behavioural 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 instance, 51 euros per session. If the therapist's costs exceed these rates, you must cover the difference yourself. An additional insurance for alternative practitioners generally does not cover these specific psychotherapy costs from alternative practitioners if the basic service is not eligible for reimbursement. It is important to carefully check the therapist's invoice and ensure all details are correct to avoid delays in reimbursement. The allowance regulations also specify how often a therapy can be extended, often requiring new applications and justifications.
Understanding the Difference: General Services of Alternative Practitioners versus Psychotherapy
While the psychotherapy services provided by alternative practitioners are generally excluded from subsidies, other alternative practitioner services may be eligible under certain circumstances. This does not apply to psychotherapeutic treatment by alternative practitioners for psychotherapy. There are separate rules for general alternative practitioner services that are not of a psychotherapeutic nature. They must be scientifically recognized and must not exceed certain maximum amounts. Reimbursement is often based on the fee schedule for alternative practitioners (GebüH), with reasonableness assessed according to comparable medical services in the fee schedule for physicians (GOÄ). It is important to strictly separate: psychotherapeutic services by alternative practitioners are almost always excluded from subsidies. Some states have significantly restricted or even completely abolished reimbursement for alternative practitioner services. Therefore, always clarify in advance with your subsidy office which specific alternative practitioner services are covered and to what extent. An alternative practitioner supplemental insurance might be an option to cover the costs of alternative healing methods that are not covered by subsidies. The subsidy regulations often contain lists of explicitly excluded methods, making individual case verification essential.
Check regulations: Keep an eye on current judgments and ordinances
State aid law is complex and subject to changes by new regulations or court rulings. What applies today may change in a few years. The federal aid regulations (BBhV) and the individual federal states (e.g., SächsBhVO) are the relevant legal bases. It is therefore essential to always stay informed of the current status. Your responsible aid office is the first point of contact for this. Specialist associations or specialized advisory centers can also provide current information on rulings regarding psychotherapy healer practitioner aid. For example, there have been adjustments to the aid regulations due to the Psychotherapy Law, which clarified the qualification requirements. This dynamic requires continuous attention to avoid disadvantages in cost reimbursement. An outpatient healer practitioner supplementary insurance can be sensible to be more flexible in reacting to changes. Note that for civil service trainees or annuitants, there may be some differing rules with specific assessment rates. Therefore, checking the individual situation is always necessary.
Secure support: Your next step towards optimal protection
More useful links
LBV Baden-Württemberg offers a document (presumably PDF) with relevant information about allowances.
LBV Baden-Württemberg provides further information on the topic of non-medical practitioners.
Bezirksregierung Arnsberg offers a leaflet (PDF) with detailed information on allowances for outpatient medical and non-medical practitioner treatments.
VBBA provides a leaflet (PDF) on allowances for non-medical practitioner services, which could be particularly relevant for seniors.
FAQ
What costs for psychotherapy does the assistance cover?
The aid covers costs for recognized psychotherapeutic procedures conducted by qualified therapists (doctors, psychological psychotherapists). Maximum rates according to GOÄ/GOP (usually 2.3 times the rate) and a limited number of sessions apply. Psychotherapy by alternative practitioners is generally not covered.
Are the regulations for psychotherapy aid uniform nationwide?
The Federal Aid Ordinance (BBhV) forms the basis for federal civil servants. The federal states have their own aid ordinances, which often follow the BBhV. However, there may be differences in detail, so it is important to examine the currently valid state ordinance.
What happens if my therapist charges higher fees than those covered by benefits?
If the therapist charges higher rates than the reimbursable maximum rates (e.g., above 2.3 times the GOÄ rate), you will need to cover the difference yourself. It is advisable to clarify the costs with the therapist in advance.
Does my private health insurance cover the gap for psychotherapy assistance?
This depends on your individual policy with private health insurance. Many policies for those eligible for state aid supplement the benefits provided by the state. Check your contract terms or ask your private health insurance provider, particularly regarding the reimbursement of psychotherapy and any potential remaining costs.
Can I take out supplementary insurance for psychotherapy with alternative practitioners?
There are <a href="/solutions/subsolutions/ambulante-heilpraktiker-zusatz">additional insurance policies for alternative practitioners</a> that cover certain alternative treatment methods. However, whether they explicitly include psychotherapy by alternative practitioners for psychotherapy and to what extent must be examined closely, as this is often excluded if civil service benefits do not cover it.
Where can I find the forms for the application for psychotherapy assistance?
The necessary forms (e.g., application for recognition of eligibility for psychotherapy benefits) can be obtained directly from your responsible aid office. These are often also available for download on the websites of the respective state offices or the Federal Office of Administration.
