Mental health

If you have statutory health insurance, you can ask for an outpatient psychotherapy consultation without a referral. This is usually the first step towards treatment, with exceptions after certain hospital or rehabilitation stays or when changing therapists. You can call 116117 for help finding an appointment.

In short

• Statutory outpatient psychotherapy usually starts with a consultation hour. After qualifying inpatient or rehabilitation treatment, or when changing therapist during ongoing therapy, a further consultation may not be required. You do not need a referral. The appointment line is 116117.
• The service has one week to arrange an appointment. For acute treatment, that appointment must be at most two further weeks away. If there is no timely slot with a contracted therapist, the service must find a hospital or hospital-outpatient appointment within a further week.
• Acute treatment for adults is generally up to 600 minutes per treatment case (four quarters), in units of at least 25 minutes. For children, adolescents and people with intellectual disabilities, up to 750 minutes are possible when relevant caregivers participate. The practice notifies the insurer; no prior application is needed. That timetable does not guarantee a regular therapy place within three weeks.
• For 116117 to arrange acute treatment, a consultation normally must recommend acute treatment on a PTV 11. After discharge from qualifying hospital or rehabilitation treatment for mental illness, contact the service directly and explain the discharge. Treatment still depends on clinical indication.
• In an emergency, call 112. A therapist without a statutory seat may charge a private fee. Ask who pays before the first session.

What you need to know

Section 75 requires the associations of statutory doctors to run appointment services, reachable 24 hours a day, seven days a week, on one national telephone number, since 1 January 2020. The 116117 site is that patient service.

For psychotherapy, section 75 applies the appointment rules to the first conversation in the consultation hour and to the timely treatment that follows from it, and it says no referral is required.

The service has one week to arrange an appointment. For acute treatment, that appointment must be at most two further weeks away: 116117 describes a total of up to three weeks. If the service cannot offer a timely slot with a contracted therapist, it must find a hospital or hospital-outpatient appointment within a further week, as the 116117 page explains.

A consultation is the usual first step. The G-BA says that, after discharge from inpatient hospital or rehabilitation treatment that was necessary because of mental illness, acute treatment or probatory sessions can begin without a prior consultation. The KBV also describes an exception when changing therapists during ongoing psychotherapy. The 116117 page describes the usual consultation route.

Acute treatment can stabilise a crisis; the G-BA describes up to 24 units of at least 25 minutes, up to 600 minutes per treatment case (four quarters) for adults. When relevant caregivers participate, up to 30 units or 750 minutes are possible for children, adolescents and people with intellectual disabilities. The practice notifies the insurer; acute treatment does not need prior approval.

The page lists four procedures that statutory outpatient therapists may use: analytic psychotherapy, systemic therapy, psychodynamic psychotherapy, and behavioural therapy. They can be individual, group, or both. Group therapy as basic care also needs no application to the insurer, according to 116117. A referral is not required. Practices must be reachable by telephone for appointments.

If you cannot find a practice, 116117 says to call. You can book a consultation without a referral code. For the service to arrange acute treatment, the KBV says the PTV 11 normally must recommend acute treatment. After a qualifying hospital or rehabilitation discharge for mental illness, you can approach the appointment service directly. Ask the service what evidence it needs.

Waiting times in a particular city can still be long for a regular therapy place. The acute-treatment timetable does not guarantee a regular therapy place within three weeks.

In an emergency, call 112. The emergencies and doctors guide explains the medical on-call service. Therapy outside the statutory contract can involve a private fee; ask the therapist about the cost before starting.

The Bundestag approved an emergency-care reform on 15 October 2026 that envisages separate appointment-service and acute-care functions under 116117. For a psychotherapy appointment, follow the current 116117 service instructions and the statutory consultation rules described above. Check the federal ministry’s reform page for implementation updates.

What to do

1. If you are in immediate danger, call 112. For a statutory appointment, call 116117 or use the online booking; ask for a consultation or explain a qualifying exception.
2. Ask whether your clinical situation calls for acute treatment or a longer therapy requiring a separate application. The consultation is the usual route, but the discharge and therapist-change exceptions above apply.
3. If a consultation recommends acute treatment on PTV 11, use its code with 116117. After a qualifying discharge, ask the service about the direct route instead.
4. Keep your statutory card. A therapist without a statutory seat can still see you, but the invoice may be private. Ask before the first session who pays.

Common mistakes

• Waiting for a family doctor referral. Section 75 and the 116117 page both say psychotherapy does not need a referral.
• Treating the acute-treatment timetable as the wait for a year of therapy. It is for acute treatment.
• Assuming that a request guarantees acute treatment or that every patient has the same allowance. Clinical indication, the treatment units and the conditional caregiver allowance matter.