No, the practice fee (Praxisgebühr) no longer exists in 2026. If you visit a doctor in 2026, you do not pay a fee simply for attending the practice. Co-payments still apply only to certain services, for example to prescribed medicines.
Short answer: The practice fee ended on 1 January 2013. The Bundestag was due to decide on its abolition in November 2012, with entry into force set for 1 January 2013 (Bundestag, text archive 2012, in German). A reintroduction is currently not decided. What you pay today depends on co-payments for prescribed services and on the statutory cap. Last updated: November 2026.
The Key Points at a Glance
- The practice fee is no longer part of the system. A doctor visit alone triggers no fee.
- The abolition was planned to take effect on 1 January 2013.
- Co-payments apply to certain services, for example prescribed medicines.
- The statutory cap limits co-payments in a calendar year to 2 percent of gross income for living expenses, or 1 percent for chronically ill patients in continuous treatment.
- A reintroduction is not decided. Changes to co-payments are covered in a separate article (in German).
What Was the Practice Fee?
The practice fee was a payment that insured people had to make when visiting a doctor. It was meant to steer the number of doctor visits. With its abolition, this payment for visiting the practice was removed.
In the Bundestag, the abolition was the subject of a bill in 2012. The Bundestag records show the bill 17/10747 in the version of the committee recommendation 17/11396, and name the abolition as its most important change.
What Do Patients Pay Today?
In today’s system, insured people pay no fee for a doctor visit alone. Co-payments apply when the law provides for them for a particular service. Depending on the service, these include prescribed medicines and other services such as medical aids.
- Medicines: co-payment per pack, where the service is subject to co-payment.
- Medical aids: insured people aged 18 and over pay a co-payment per aid, and exemptions follow the statutory rules.
- Hospital: co-payment per stay or per day, depending on the rules.
- Doctor visit itself: no practice fee any more.
Which co-payment applies in an individual case depends on the service, your age and any possible exemption. Your health insurer can give you the details for your case.
The Statutory Cap: When You No Longer Have to Pay
Co-payments are only due in a calendar year up to the statutory cap. The cap is 2 percent of annual gross income for living expenses, or 1 percent for chronically ill patients in continuous treatment for the same serious illness. After that, the health insurer issues a certificate of co-payment exemption (Section 62 SGB V).
Assumption: an insured person has gross income for living expenses of 1,000 euros per month, that is 12,000 euros per year, with no other relatives in the household. The calculation shows the cap for two income levels.
| Assumed annual income | Cap at 2 percent | Cap at 1 percent (chronically ill) |
|---|---|---|
| 12,000 euros | 240 euros per calendar year | 120 euros per calendar year |
| 24,000 euros | 480 euros per calendar year | 240 euros per calendar year |
These amounts are worked examples. The actual cap depends on your income and household situation. Relatives living in the same household reduce the income under the rule in Section 62 (2) SGB V.
How to Track Your Co-Payments During the Year
Because the cap refers to the calendar year, it is worth recording your co-payments as you go. A simple overview prevents you from paying too much or applying for the certificate too late.
- Keep receipts for prescribed medicines and medical aids separately for each calendar year.
- Note the amounts as you go, so you can see when the cap has been reached.
- Ask your health insurer which evidence it needs for the certificate of co-payment exemption.
- Check at year end whether you have already reached the cap before making further co-payments.
Is a New Fee on the Horizon?
A reintroduction of the practice fee is currently not decided. In health policy, the level of co-payments is currently more in the focus. According to the federal health ministry (BMG), the Bundestag passed the GKV contribution stabilisation act (GKV-Beitragssatzstabilisierungsgesetz) on 10 July 2026. Which co-payments rise in it can be taken from the law text, and our article on 2027 co-payments summarises the rules (in German).
What This Means for Students in Statutory Health Insurance
If you are a student with statutory health insurance, the same co-payment rules apply to you as to other members. What matters is therefore not your status as a student but the service prescribed and the annual cap. If you want to avoid co-payments during your studies, pay attention above all to the total for the calendar year.
Whether you are insured as a student with your health insurer or through family insurance affects contributions, not the practice fee. Co-payments remain unaffected by this, as long as you are statutorily insured.
Frequently Asked Questions
Do I have to pay anything at my first doctor visit in a quarter?
Not because of a practice fee. Co-payments only apply to certain services, for example prescribed medicines. No fee is charged for the doctor visit itself.
What is the statutory cap?
The statutory cap is the maximum you pay in co-payments in a calendar year. It is 2 percent of gross income for living expenses, or 1 percent for chronically ill patients in continuous treatment. Once you reach it, the health insurer issues a certificate.
Do co-payments from the previous year count?
No. The cap applies per calendar year. Co-payments from the previous year do not count for the current year, so the count starts again at zero in January.
Who decides on exemptions from co-payments?
Your health insurer checks exemptions and issues the certificate. Details of the procedure are on your insurer’s website and in the linked guide on applying for co-payment exemption (in German).
Is there a practice fee in another form?
This question refers to models such as steering fees. Currently, no such fee has been introduced. The debate about steering instruments exists, but it has not produced a verified rule for 2026.
Where can I find the current co-payments?
The relevant provisions are in the Social Code Book V (SGB V). Your health insurer gives reliable information on your case, and the statutes are publicly accessible.
What to Do Now
- Check whether your doctor visit triggers a co-payment before you pay at the practice or pharmacy.
- Add up your co-payments for the calendar year so that you do not miss the cap.
- Ask your health insurer for the certificate of co-payment exemption as soon as the cap is reached.
- Follow changes in the legislative process on the ministry’s website.
Related Articles
- Health system reform: all topics at a glance (hub, in German)
- Co-payments 2027: what the GKV contribution stabilisation act changes
- Applying for co-payment exemption: forms, evidence and deadlines
- Pharmacy co-payment 2027: what changes per medicine
- Hospital co-payment 2027: what a stay costs patients
Sources: Bundestag, text archive 2012: practice fee (status as stated on the page, planned date), Section 62 SGB V, statutory cap, Gesetze im Internet (in German) and Bundestag passes GKV contribution stabilisation act, BMG press release of 10 July 2026 (in German).
Last updated: November 2026. This guide is general information, not individual advice.
