Psychotherapeutic treatment
The psychotherapeutic treatment includes all activities of psychotherapists for the prevention, early detection and treatment of mental disorders . In many countries, psychotherapeutic treatment is a social security benefit .
Psychotherapeutic treatment in Germany
In Germany, the majority of psychotherapeutic treatments are part of the service catalog of the statutory health insurance (GKV). The legal entitlement to this is anchored in Section 28 (3) SGB V. People who are not insured by the statutory health insurance usually appear as private patients (self-payers) with the psychotherapist . You almost always have contracts with private health insurances whose subject matter is the reimbursement of the costs of psychotherapeutic treatment. Eligible beneficiaries are also entitled to benefits. In the statutory accident insurance , psychotherapeutic treatment is also part of the service catalog. Psychotherapeutic treatment also includes the services of other people, e.g. B. Employees of the psychotherapist, if their activity can be delegated and is ordered and monitored by the responsible psychotherapist.
Basically, in Germany there is a free choice of psychotherapist , whereby the admission of the psychotherapist as a contract psychotherapist is a performance requirement for patients with statutory health insurance . If this is the case, the psychotherapeutic treatment can be claimed in kind with the help of the electronic health card (eGK). The services that the psychotherapist has provided for his patient are then billed to the responsible health insurance company via the Association of Statutory Health Insurance Physicians. Benefits that go beyond the GKV's catalog of benefits can be used privately by the legally insured after a written agreement. These include, for example, so-called individual health services (IGEL).
Scope of services
The content of contract psychotherapeutic care is stipulated by law in Section 73 (2) SGB V.
- psychotherapeutic care
- Issuing of certificates and preparation of reports that the health insurance companies or the medical service need to carry out their statutory tasks or the insured persons in connection with the right to continued payment of wages. The health insurance companies have a limited number of forms available for this, which are specified in a form agreement.
- Prescription of sociotherapy, psychotherapeutic rehabilitation measures, hospital treatment and patient transport.
Further details on the content of the contractual psychotherapeutic services are contractually regulated between the health insurance companies and associations of statutory health insurance physicians or decided by the Federal Joint Committee in its guidelines in accordance with Section 92 (1) sentence 2 numbers 6, 8 and 12.
Free choice of psychotherapist
Free choice of psychotherapist means that the patient can generally turn to a freely chosen psychotherapist he / she trusts for treatment. However, the law provides a framework of psychotherapists and psychotherapeutic institutions from which the insured can choose. These are essentially:
- Licensed contract psychotherapists
- employed licensed psychotherapists in a medical care center (MVZ)
Psychotherapists who do not belong to the aforementioned groups of people or institutions may only be used by those with statutory health insurance in strictly defined exceptional cases. Such a case would be e.g. B. if no contract psychotherapist could be reached in the event of an emergency, or there is no free psychotherapy place available in the vicinity of your home despite a reasonable waiting time. On request, the treatment costs are covered by the health insurance companies in the so-called cost reimbursement procedure .
In the case of the so-called total hospital admission contract, the patient's consent does not refer to the treatment of a specific psychotherapist. Rather, in view of Section 613 BGB, every psychotherapist provided for in the roster is authorized to provide treatment.
Transfers
In health care, a psychotherapist refers to a doctor when he orders a consultative examination. For this, the psychotherapist gives his patient a specially designed form (referral slip).
Like the insurance card, the referral slip is proof that the patient in question is eligible for benefits in kind under the statutory health insurance scheme . The referral slip is required to settle the treatment with the Association of Statutory Health Insurance Physicians. The details are regulated in the federal shell contract.
Ensuring psychotherapeutic care
In order to ensure adequate, appropriate, economic and necessary psychotherapeutic treatment for those with statutory health insurance, the legislature has assigned the so-called security order to the associations of statutory health insurance physicians . The Association of Statutory Health Insurance Physicians conclude contracts with the health insurances regarding the modalities and remuneration, whereby the fifth book of the Social Security Code (SGB V) sets narrow limits for the contracting parties.
In 2012, there were around 22,000 certified psychotherapists working in Germany. In addition, there are purely private psychotherapy practices.
In 2015, the registered psychological psychotherapy practices in Germany were divided into 20,021 individual practices, 592 group practices and 25 mixed medical-psychological group practices.
See also
- List of psychotherapy and self-awareness methods
- Medical treatment
- uniform evaluation standard (EBM)
- Federal Joint Committee
Individual evidence
- ↑ KVB: In future, psychotherapists may also prescribe. March 16, 2017. Retrieved July 8, 2017 .
- ↑ cf. BGH, judgment of May 11, 2010 , Az. VI ZR 252/08, full text.
- ^ Jens Lubbadeh: Lack of psychologists in Germany Desperately looking for a therapist. Spiegel-Online, July 5, 2012, accessed July 1, 2017 .
- ↑ Outpatient supply structures. In: health data. KBV, 2017, accessed on July 2, 2017 .
