If you cannot find a therapy slot with a psychotherapist who has a contract with your health insurance provider, that does not mean your options are exhausted. Under certain conditions, individuals with public health insurance can also receive treatment from therapists who are not approved by their health insurance provider and have the costs reimbursed. The legal basis for this is Section 13(3) of Book V of the Social Code (SGB V).
That is sufficient for approval PTV11-The form alone is not sufficient, but it must clearly demonstrate three things: that outpatient psychotherapy is necessary, that treatment cannot be provided at the referring practice itself, and that it is needed promptly. The latter is demonstrated by the Urgency Code documented.
In addition to the PTV-11 form, you’ll need other documents: a medical certificate of urgency, the consultation report, and a documented list of unsuccessful inquiries to health insurance-affiliated practices. Include the practice name, date, time, and result for each individual call.
Don't just use these calls to take rejections in stride—use them to get to know other psychotherapists as well. To learn how to quickly build relationships with other psychotherapists and secure a therapy spot as soon as possible with someone who's a good fit for you, read here: Search for a Psychotherapist.
Only the complete package, along with the application, is submitted to the statutory health insurance provider. The provider must make a decision within three weeks—a deadline that provides planning certainty, even if the wait until then may seem long.
