Preliminary Hearing: Costs, Number and Schedule

Anyone looking for a spot in therapy will soon come across a term that sounds administrative but refers to something very practical. The probatory phase is the stage before psychotherapy begins, during which you and your therapist figure out whether you can work together.

The cost of these appointments depends almost entirely on your insurance coverage. At an approved practice, statutory health insurance covers the full amount. Privately insured patients receive an invoice based on the fee schedule and submit it to their insurance company. Anyone who comes without insurance coverage must pay out of pocket.

The figures are listed below, broken down by these three options. Before that, it’s worth taking a look at what actually happens during these sessions and how many are scheduled. Without knowing the number of sessions, the price per session is only half the story.

A preliminary consultation is a discussion that takes place before starting a standard treatment regimen. The Psychotherapy Guidelines Section 12 of the Joint Federal Committee’s regulations lists three practical purposes: further diagnostic clarification of the clinical picture, further determination of the indication, and assessment of whether you are a suitable candidate for a specific psychotherapy method.

One sentence in the same regulation stands out from the rest. The sessions also serve „to assess personal compatibility, that is, a sustainable working relationship between the patient and the psychotherapist.“ Whether there is “chemistry” between them is thus explicitly stated in the regulations and is not merely a soft, supplementary consideration.

In practical terms, this means: These appointments are a test for you, too. You may say no afterward without giving a reason, and you may do so even if nothing went wrong from a professional standpoint. For the patient, the trial period is the only phase in which experimentation is expressly intended.

Before starting guideline-based treatment, determine at least two and up to four These appointments take place. For children, adolescents, and people with intellectual disabilities, there are two additional appointments, for a total of up to six. An individual session lasts 50 minutes; a group session lasts 100 minutes.

They are set forth in Section 12, Paragraph 3 of the Psychotherapy Guidelines and apply to statutory health insurance. This is not a guideline value. Probationary sessions have a minimum and a maximum limit: guideline-based therapy does not begin with fewer than two sessions, and the insurance provider does not cover more than four sessions for adults.

One point that often gets overlooked: These sessions do not count toward your therapy quota. If, at a later date, a Short-term therapy lasting 24 hours If it is approved, you will receive 24 hours of psychotherapy, not 24 minus four.

At a practice that’s approved by your health insurance provider, you pay nothing. You simply present your insurance card, and the practice bills the Association of Statutory Health Insurance Physicians directly. There are no additional payments or copayments; the costs are covered for you without you having to do anything.

No application is required for this either. The Federal Chamber of Psychotherapists explains this on its Patient Page Without exception: „You don’t need to submit a claim to your health insurance provider yet for the initial sessions. Your health insurance provider will cover the costs in any case.“ The claim comes later, for the psychotherapy itself.

What the health insurance provider covers is publicly available. The Uniform Assessment Scale lists the service under code 35150 with 709 points, which amounts to exactly in 2026 90.33 euros for every full 50 minutes. The money goes directly to the practice, not through you. For more information, see the overview of the Billing for Probation Hearings.

One condition underlies this entire section: The practice needs to be licensed to provide insurance-covered care. The Joint Federal Committee states that insured persons may „contact a contracted psychotherapist directly—that is, medical or psychological psychotherapists who are licensed to provide services under the statutory health insurance system.“ This provision does not apply to practices that operate exclusively on a private basis, even if you have statutory health insurance.

Privately insured patients receive a bill. This is based on the Schedule of Fees for Physicians (GOÄ). One often reads that patients can choose between the GOÄ and the Schedule of Fees for Psychological Psychotherapists (GOP). This is a misunderstanding: The GOP is a brief regulation that refers to the GOÄ in Section 1. Which of the two appears in the letterhead depends on the profession of the person issuing the bill, not on your insurance status.

The amount is calculated based on three factors: the score for the course, the point value of 5.82873 cents, and a multiplier. For Probatorik, there is No separate item number, billing is based on the specific psychotherapy method.

A 2.3-fold increase is the norm, not the best-case scenario. Section 5, Paragraph 2 of the GOÄ Although it permits up to 3.5 times the standard rate, this is only allowed „if specific circumstances related to the assessment criteria mentioned in the first sentence justify it,“ and Section 12, paragraph 3 requires a written justification for this on the invoice.

The joint billing recommendations issued by the German Medical Association, the German Chamber of Psychotherapists, the Association of Private Health Insurance Companies (PKV), and the government-sponsored health insurance providers clarify just how strictly this is interpreted: „Exceeding 2.3 times the standard fee rate is generally not permitted.“ The same source clarifies that concomitant mental and physical conditions or a chronic course of the illness are expressly not considered such special circumstances.

In addition to the appointment fee, some practices bill code 801 for the assessment of the patient’s current mental health status, which currently amounts to 33.52 euros. This is neither a flat fee nor an automatic charge: it requires medical necessity and a time commitment that exceeds the minimum duration of the session. Anyone who reads online about amounts around 134 euros per appointment is usually referring to exactly this total, made up of two separate charges.

Whether your insurance will reimburse the amount is a separate issue. It depends on your plan, and the billing guidelines state this as well: „For private health insurance companies, this depends on the plan.“ The fact that the bill is correct doesn't change anything. You owe the practice the full amount, even if the insurance company pays less.

Those eligible for public assistance should not be included in the same paragraph as those with private insurance. A separate set of rules with its own figures applies to them, including for psychotherapy.

According to the Federal State Aid Regulation, up to five These appointments are possible; in the case of analytical psychotherapy, up to eight. Unlike under statutory health insurance, they are not only permitted but mandatory. This applies to the federal subsidy; the states may have different rules, so it’s worth checking your state’s subsidy regulations.

Self-pay patients are people who do not have insurance coverage. Some do not want a diagnosis on their records, others do not want to wait, and still others are seeking psychotherapy that their insurance does not cover.

A common misconception is that the price is then freely negotiable. It is not. Section 1 of the GOÄ is based on professional services, not on insurance status, and Section 1 of the GOP refers psychological psychotherapists to that provision. The table above therefore applies here as well.

A practice may deviate from this, but only in the form of the Sections 2 of the GOÄ: In writing, on a case-by-case basis, prior to treatment, specifying the number, description, rate of increase, and amount, and noting that reimbursement may not be made in full. A verbal agreement over the phone does not satisfy this requirement.

This is a question that comes up often, and it's a valid one: Is it okay for a patient to visit two or three practices before making a decision?

I have not found an official response addressed directly to patients on this matter. However, the billing rule does provide one. Code 35150 can be billed „no more than 4 times per illness,“ and according to Section 21 of the Federal Framework Agreement, the illness must be treated at „the same medical practice.“. So the counter tracks the number of practices, not the number of people.

It follows, then, that a second practice has its own counter and can accommodate up to four appointments there as well. This is based on the billing process and does not constitute a commitment from your health insurance provider. If this is important to you, check with them briefly before scheduling multiple initial consultations at the same time.

If you agree, a request for standard treatment will follow. This request may be submitted as early as the first of these appointments, and additional requests may be made thereafter.

For those with public health insurance, the consultation report is required: a confirmation from a doctor that no physical cause has been overlooked. The requirements for this are listed on the page for the Consultation Report. Which Ways to Get to the Therapy Site It is mentioned elsewhere.

If you decide not to continue after the sessions, that’s the end of it. There are no disadvantages to this, and you will still be eligible for psychotherapy.