Psychotherapy by video sounds like a convenient option, especially when appointments are hard to fit into the semester or when the way to the practice is long. The rules are not arbitrary, however. This guide shows which parts of a treatment may take place by video according to the Kassenärztliche Bundesvereinigung (KBV, the German National Association of Statutory Health Insurance Physicians), where the limits lie and what applies in a crisis.
Short answer: According to the KBV press note of 19 December 2024, psychotherapy consultations and probatory sessions may take place by video from 1 January 2025. At least 50 minutes of the consultations and of the probatory sessions should still take place in person. Purely virtual treatment is permitted only in justified exceptional cases. Billing follows the psychotherapy agreement and the EBM fee schedule. Last updated: November 2026.
The most important points at a glance
- The psychotherapy agreement expressly allows video consultations and probatory sessions from 1 January 2025. Until then this applied only to acute treatment and to individual and group therapy.
- At least 50 minutes of the consultations and at least 50 minutes of the probatory sessions should take place in direct personal contact.
- Purely virtual treatment is only provided for in justified exceptions, for example when the practice cannot be visited for health reasons.
- In a crisis, therapists must ensure, in every video treatment, that suitable follow-up care is guaranteed where medically necessary.
- The billing and details of cost coverage should be clarified with the practice and your health insurer, because the rules are tied to the EBM.
Which parts of psychotherapy may take place by video?
The question matters because not every phase is regulated in the same way. The table summarises the KBV information. It describes the status of the press note and does not replace information from the practice in an individual case.
| Service | Video according to the KBV | Requirement |
|---|---|---|
| Psychotherapy consultation | Expressly allowed from 1 January 2025 | At least 50 minutes in person |
| Probatory sessions | Expressly allowed from 1 January 2025 | At least 50 minutes in person |
| Acute treatment | Already possible by video before | Details per practice and rules |
| Individual and group therapy | Already possible by video before | Details per practice and rules |
The first consultation and the first probatory session should preferably take place in the practice. Those who experience this entry in person have a better basis for continuing by video later. Details of the consultation are in Psychotherapy consultation: what it is and how to book it.
When is purely video-based treatment permitted?
According to the KBV, treatment exclusively by video is permitted only in justified exceptional cases. The press note gives as examples the case that the practice cannot be visited for health reasons, and the case that the patient expressly wishes it.
The practice decides whether such an exception applies to your situation. You can raise the wish openly and ask which reasons must be met. There is no guarantee of purely video appointments.
What applies in a crisis?
In video treatment, therapists must ensure in a crisis that suitable follow-up care is guaranteed where medically necessary. According to the KBV, this applies to all video sessions in psychotherapy. You should therefore clarify in the conversation what is agreed for an acute situation.
Independently of the practice, the rule is this: in acute distress, speak to a trusted person and contact the emergency services. According to the German federal government, the Telefonseelsorge (telephone counselling service) can be reached around the clock free of charge on 0800 1110111 and 0800 1110222.
How do you find an appointment that can be held by video?
The 116117 service arranges appointments with psychotherapists. According to the Verbraucherzentrale, the number is reachable 24 hours a day, and for the consultation the maximum waiting time between the call and the appointment is four weeks. Ask at the first contact whether the practice offers video. More on the referral is in Arranging psychotherapy through the 116117 service.
What does this mean for the costs?
Billing for psychotherapy follows the psychotherapy agreement and the uniform assessment standard (EBM). The KBV points out that the assessment committee is still reviewing and may change the EBM. You should therefore clarify questions about cost coverage before the first appointment, rather than relying on information from older sources.
For how reimbursement works in private health insurance, see PKV and psychotherapy: what is covered? (in German). For statutory insurance, the rules of the respective fund and the care system apply.
Which questions should you clarify before the first video appointment?
A first video appointment differs from a conversation in the treatment room mainly in its setting. You sit at home or on the move, and the connection can cause problems. It is therefore worth agreeing on the process in advance, so you can concentrate on the content of the conversation. The following points help with preparation, but they are not a binding list.
- Which platform the practice uses for video appointments and whether you need an account or an app for it.
- How the practice handles interruptions or dropped connections and who calls you back in that case.
- Where you should be during the video session so that the conversation stays undisturbed, and which documents you keep at hand.
- What is agreed for a crisis between appointments, for example who can be reached and which numbers apply.
The practice usually explains its data protection rules in its privacy notice. Read it in advance if the protection of personal details matters to you. You can also ask about this in the first conversation, before you discuss things that affect you deeply.
Frequently asked questions
Is a video session as good as an appointment in the practice?
That cannot be said in general. The KBV stresses that personal contact remains the rule and that at least 50 minutes of the consultations and probatory sessions should take place in person. Video sessions complement care rather than fully replace it.
Do I need special technology?
The practice determines which route video sessions use. Ask in advance about the technical requirements so that the appointment does not fail because of a connection or an app. This guide does not list a binding technical checklist, because it varies by practice.
Can I switch to in-person sessions after a video session?
Yes, this is generally possible if the practice and your situation allow it. Raise the wish openly. You decide together, and according to the KBV, personal contact is the rule.
Does this also apply to group therapy?
The KBV press note names group therapy as an area in which video was already possible before. The details of implementation depend on the practice and the rules in force at the time.
What to do now
- Ask the practice whether the consultation and probatory sessions take place partly by video and how the in-person share looks.
- Clarify with your health insurer and the practice how billing works before you book the first appointment.
- Agree on what applies in a crisis, and note the numbers of the Telefonseelsorge and 116117.
Related guides
- Probatory sessions in psychotherapy
- Psychotherapy consultation: what it is and how to book it
- Telemedicine Private Insurance: Video Calls and Costs
- Private Health Insurance and Psychotherapy: Costs
Sources:
Kassenärztliche Bundesvereinigung: Press note of 19.12.2024 on video consultations in psychotherapy (German)
Kassenärztliche Bundesvereinigung: Psychotherapy, questions and answers (undated, German)
Federal Government of Germany: Hotlines for help and crisis (archived page without date, German)
Verbraucherzentrale: Appointment with a specialist within 4 weeks, status 01.10.2024 (German)
Last updated: November 2026. This guide is general information, not individual advice.
