Psychotherapy in statutory and private health insurance as a student differs mainly in waiting times, costs and the application process. Anyone who needs therapy has to take different routes in each system, and in statutory insurance the deadlines are clearly set by law. This guide explains the steps and the points to clarify before you book.
Short answer: Statutory insurance members need no referral for the first consultation at a psychotherapy outpatient consultation, and the appointment should be arranged within one week. For acute psychotherapy, the waiting time may not exceed two weeks (§ 75 para. 1a SGB V, last updated October 2026). The statutory insurer covers approved treatment under the psychotherapy guideline. Under private health insurance (PKV), reimbursement depends on your tariff.
The most important points
- The first consultation at a psychotherapy outpatient consultation needs no referral under the statutory system.
- For the first consultation, the appointment should be arranged within one week. Acute psychotherapy may not wait longer than two weeks.
- In the statutory system, the therapist applies to the health insurance fund, which decides after an expert review (Gutachterverfahren).
- Under PKV there is no statutory referral or application procedure. A cost confirmation in advance is worth requesting.
- Whether your tariff reimburses psychotherapy, to what extent and under which fee schedule is set out in the tariff conditions.
How psychotherapy works under statutory insurance
Statutory care usually starts with a consultation at a psychotherapy outpatient clinic. There a psychotherapist clarifies whether treatment is needed and which method fits. Usually trial sessions follow (probatorische Sitzungen), whose scope is set by the psychotherapy guideline of the Federal Joint Committee (G-BA).
Only after that does the therapist apply to the health insurance fund. The fund then decides through an expert review. For statutory members this is the normal route, and it usually takes longer than the first consultation itself.
Waiting times: what the deadlines mean
Under statutory insurance, the central appointment service arranges appointments within legal deadlines. The rules are in § 75 para. 1a SGB V. The table summarises the points that matter for psychotherapy.
| Situation | Deadline under the law | Note |
|---|---|---|
| First consultation at a psychotherapy outpatient clinic | One week | No referral needed |
| Acute psychotherapy | At most two weeks | Applies to the wait for the start of treatment |
| Specialist appointment via the central appointment service | At most four weeks | Referral generally needed |
You reach the central appointment service through the nationwide number 116117. Whether a deadline is met in your case also depends on how quickly you respond and how flexible you are with dates. In an acute crisis, call the emergency number 112 or go to a hospital emergency department.
Costs under statutory and private insurance
Under the GKV, the fund covers approved psychotherapy, and you generally have no own costs for the treatment itself. Under PKV, the therapist bills under the fee schedule, and reimbursement follows the tariff. Many tariffs cap benefits per year or per session, and some reimburse only certain methods.
| Point | Statutory insurance | Private insurance |
|---|---|---|
| First consultation | Via the outpatient clinic, no referral | Depends on the practice and tariff |
| Application | The therapist applies to the fund | No statutory application procedure, cost confirmation advisable |
| Own share | Generally none for approved treatment | Depends on the tariff, a deductible may apply |
| Method | Under the psychotherapy guideline of the G-BA | Reimbursement depends on the method and tariff conditions |
How the application works at the health insurance fund
- You look for a practice with free places, directly or through the central appointment service.
- At the first consultation, the therapist clarifies your needs and a suitable method.
- After the trial sessions, the therapist applies to your health insurance fund.
- The fund decides after an expert review, and you receive a written decision.
If you wonder whether you have to file the application yourself: as a rule, the practice handles it. Ask at the first consultation how the process works in your case and when a decision is likely.
Psychotherapy under PKV: what your tariff needs to clarify
Under PKV there is no statutory application like in the GKV. A cost confirmation from the insurer before you start is therefore sensible. Check in advance whether your tariff reimburses outpatient psychotherapy, whether there is a limit per year or per session, which fee schedule applies, and whether waiting periods apply to this benefit.
Choosing between GKV and PKV is not a matter of right or wrong. Statutory care suits you if you find a place quickly through the consultation route and are comfortable with the methods offered by statutory practices. PKV can suit you if you want a particular practice or your tariff offers higher reimbursement. PKV premiums can change over time, and that belongs in the calculation. For a broader comparison, read PKV or GKV as a student (in German).
Frequently asked questions
Do I need a referral for psychotherapy?
Not for the first consultation at the psychotherapy outpatient clinic. For specialist appointments through the central appointment service, a referral is generally needed. If you are unsure, ask the practice which documents it needs.
What does the statutory insurer pay for psychotherapy?
For approved treatment, the GKV covers psychotherapy under the psychotherapy guideline of the G-BA. That guideline sets out which methods are possible and how much treatment is available. If you are unsure about the process, the therapist can explain the application route.
Can I receive psychotherapy as a privately insured person?
Yes. Privately insured people can choose their psychotherapist freely. How the costs are covered is set out in the tariff. Ask in advance which fee schedule is used and whether your tariff reimburses these methods.
What is cost reimbursement under statutory insurance?
Cost reimbursement under § 13 SGB V is an option in which you pay for services first and the fund reimburses the costs. You must inform the fund before you use the service. This is a different route from the benefit in kind, where the therapist deals with the fund directly, and it should be clarified beforehand.
What should I do in an acute crisis?
If someone is at acute risk, call 112 or go to the nearest emergency department. The on-call medical service is reachable through 116117. These notes are not a substitute for treatment. They only make the next step clear.
What to do next
- Find out whether you are insured under statutory or private insurance, because the deadlines and application route depend on it.
- Arrange a first consultation through the central appointment service or directly with a practice, and note the date and result of each request.
- Under PKV, get written confirmation of what your tariff covers before you start therapy.
- Keep all letters from your fund or insurer so you can trace decisions later.
Related articles
- PKV and psychotherapy: what is covered? (in German)
- Statutory health insurance as a student: experiences, costs, limits (in German)
- Health insurance for students: glossary from A to Z
- Student dental insurance: is it worth it?
- Student Health Insurance Germany 2026: Rates and Example
Sources: Social Code Book V (SGB V), § 75 para. 1a (central appointment service), gesetze-im-internet.de, last updated October 2026; Social Code Book V (SGB V), § 13 (cost reimbursement), gesetze-im-internet.de, last updated October 2026; Psychotherapy guideline of the Federal Joint Committee (G-BA), version of 17 June 2026
Last updated: October 2026. This guide is general information, not individual advice.
