Guide to Reimbursement
by Public Health Insurance
In my private practice, I offer psychotherapy for self-paying clients as well as for patients with private health insurance. It is also possible for statutory/public health insurance (GKV) providers to cover the costs of psychotherapy through the so-called reimbursement procedure ("Kostenerstattungsverfahren").
What's the 'Reimbursement' Procedure?
The reimbursement procedure applies if you can prove that you were unable to find a therapy spot with a statutory health insurance therapist within a reasonable time or in an acceptable distance. In this case, you can apply to your health insurance provider to cover the costs of treatment in my private practice.
What Do You Need Before Coming to Me?
To increase the chances of your reimbursement application being approved, it is important to complete the following steps before we can start:
1. Call your insurance provider
Call your health insurance provider to find out what documents and steps are required for the reimbursement process.
2. PTV-11 Form
Call 116 117 (KV Berlin telephone hotline) to schedule a psychotherapeutic consultation with a public health insurance psychotherapist in order to obtain the PTV-11 form.
3. Medical Certificate
Obtain a certificate from your general practitioner or psychiatrist confirming the necessity of psychotherapeutic treatment ("Konsiliarbericht")
4. Proof of Unsuccessful Therapist Search
Contact at least 3–5 statutory health insurance psychotherapists and document their rejections or long waiting times in writing (therapist's name, date of inquiry, response).
5. Informal Application for Insurance
Prepare an informal application to your health insurance provider explaining why timely treatment is necessary and stating that you were unable to find a therapy spot with statutory health insurance therapists.