German therapy terms, explained in the order you meet them

What is 116117, the Terminservicestelle?

116117 is the national phone number and app of the Terminservicestellen, the appointment services run by the Kassenärztliche Vereinigungen. For psychotherapy, it has to offer you an appointment within one week of your request, for a date no more than four weeks away. For Akutbehandlung the wait may be at most two weeks. It books appointments; it is not a crisis line. If you are in danger, call 112.

What is a psychotherapeutische Sprechstunde?

The Sprechstunde is the first appointment with a psychotherapist on GKV. It works out whether you need treatment and what kind. You need no referral, only your insurance card. For adults it runs to a maximum of 150 minutes, split into units of at least 25 minutes. Every therapist with a Kassensitz has to offer Sprechstunden, so you can book one directly with a practice or through 116117.

What is the PTV 11 form?

PTV 11, the "Individuelle Patienteninformation", is the form you get at the end of the Sprechstunde. It records whether the therapist recommends treatment, which kind, and whether outpatient psychotherapy is "zeitnah erforderlich" (needed soon). It also carries a code that 116117 asks for before it books trial sessions or Akutbehandlung for you. Keep the original. A Kostenerstattung request almost always needs a current PTV 11 with the "zeitnah erforderlich" box ticked.

What is Akutbehandlung?

Akutbehandlung (acute treatment) is short-term help for people in an acute crisis, started without waiting for an insurer's approval. Adults can have up to 24 units of 25 minutes, the same as 12 sessions of 50 minutes. The therapist only notifies your Krankenkasse. Ask for it by name at your Sprechstunde if things feel urgent.

What are probatorische Sitzungen?

Probatorische Sitzungen are trial sessions before therapy proper. Adults have at least two and at most four of them (children and adolescents up to six). The therapist uses them to finish the diagnosis, and you use them to find out whether the two of you can work together. If the fit is wrong, you can do trial sessions with someone else.

What is a Konsiliarbericht?

Before a psychological psychotherapist can apply for your therapy, a doctor with a GKV practice has to check for a physical cause of your symptoms and write a short report, the Konsiliarbericht. Your GP (Hausarzt) usually does it. The therapist hands you the form during the trial sessions. A hospital discharge letter does not count as a replacement.

What are Kurzzeittherapie and Langzeittherapie?

These are the two lengths of Richtlinientherapie, the therapy GKV pays for. The therapist applies to your Krankenkasse for it after the trial sessions.

• Kurzzeittherapie (short-term therapy): up to 24 sessions, approved in two blocks of 12. It usually needs no external review.
• Langzeittherapie (long-term therapy): a larger allowance that depends on the method. In the first step that is up to 60 sessions for behavioural therapy (Verhaltenstherapie) or depth psychology (tiefenpsychologisch fundierte Psychotherapie), 160 for analytic therapy and 36 for systemic therapy, with extensions possible.

By law your Krankenkasse has to decide on an application within three weeks, or five weeks if it asks for an expert opinion. If it misses that deadline without telling you a sufficient reason, the application counts as approved (§13 Abs. 3a SGB V).

What is the Gutachterverfahren?

The Gutachterverfahren is an external review of the therapist's treatment plan. An independent expert reads an anonymised report and recommends whether the insurer should approve it. It is required for the first application for Langzeittherapie. Kurzzeittherapie normally skips it.

What is a Kassensitz?

Kassensitz is the everyday word for a Kassenzulassung, a therapist's approval to bill GKV directly. The number of seats per region is capped through a planning system called Bedarfsplanung, which is the main reason Kassensitz therapists have long waiting lists. A therapist without one can still be fully licensed. They simply can't bill your Krankenkasse directly, so you pay privately, claim from a private insurer, or use Kostenerstattung.

What is Approbation, and who can call themselves a Psychotherapeut?

Approbation is the state licence to practise psychotherapy. Only people who hold it, and doctors with the matching specialist training, may use the title Psychotherapeutin or Psychotherapeut (§1 PsychThG). Some similar-sounding titles mean something different:

• Psychologe or Psychologin: someone with a degree in psychology. The degree alone is not a licence to treat.
• Heilpraktiker für Psychotherapie: a permit under the Heilpraktiker law, granted after an exam at the local health office. It is a different qualification from Approbation, and GKV does not pay for it.
• Coach or Berater: not a regulated title at all.

To check someone, ask whether they are approbiert, or look them up in the register of the Psychotherapeutenkammer for their state.

What is Kostenerstattung?

Kostenerstattung (cost reimbursement) under §13 Abs. 3 SGB V applies when your Krankenkasse can't provide a treatment that can't wait in time. You may then see a licensed therapist without a Kassensitz, and your insurer reimburses the cost. Insurers usually ask for a current PTV 11 marked "zeitnah erforderlich", a log of the Kassensitz practices you contacted with dates and answers, and a written application sent before the first private session. Only therapists with an Approbation qualify.