Physical Therapy Costs in Germany

Jul 8, 2025

|

Last updated:

Jul 8, 2025

9 MIN READ

Reviewed by:

Jesaja Brinkmann

Founder & CEO, Somana

Medical studies at University of Würzburg and Hamburg; Research at Harvard Medical School.

Thinking about starting physical therapy in Germany but worried about the costs? That's completely understandable. This article covers everything you need to know about physical therapy costs in the German healthcare system – from insurance coverage to out-of-pocket prices. I'll explain transparently what expenses you can expect and how to keep your costs under control.

Physical Therapy Costs in Germany

Jul 8, 2025

|

Last updated:

Jul 8, 2025

9 MIN READ

Reviewed by:

Jesaja Brinkmann

Founder & CEO, Somana

Medical studies at University of Würzburg and Hamburg; Research at Harvard Medical School.

Thinking about starting physical therapy in Germany but worried about the costs? That's completely understandable. This article covers everything you need to know about physical therapy costs in the German healthcare system – from insurance coverage to out-of-pocket prices. I'll explain transparently what expenses you can expect and how to keep your costs under control.

Insurance Coverage: Will My German Health Insurance Cover physical therapy?

The good news first: Yes, physical therapy is covered by all statutory health insurance companies (gesetzliche Krankenkassen) in Germany when medically necessary. The requirement: You need a doctor's prescription (Heilmittelverordnung).

Your insurance covers 90% of the treatment costs. As a statutory insurance holder, you pay:

  • 10% of treatment costs as co-payment

  • Plus a one-time €10 prescription fee per referral

Co-payments: How Much Does physical therapy Cost with a Prescription in Germany?

With a doctor's prescription, statutory insurance holders must pay the following amounts directly to the physiotherapist:

1. Prescription fee: €10 one-time This applies per prescription – whether 6 or 20 sessions are prescribed.

2. Co-payment: 10% of treatment costs With typical insurance rates of €20–40 per session, this means about €2–4 additional per session.

Example calculation: 

  • Physical therapy (20 min) costs insurance about €27.80

  • Your co-payment: €2.78 per session

  • For 6 sessions: €10 prescription fee + €16.68 (6 × €2.78) = €26.68 total co-payment

Info Box: Co-payments at a Glance Prescription fee: €10 (one-time per prescription) Plus: 10% of treatment costs per session Applies to everyone over 18 without exemption

Exemptions: Who Doesn't Have to Pay Co-payments?

You're exempt from co-payments if you belong to one of these groups:

  • Children and teenagers under 18

  • Pregnant women for pregnancy-related conditions

  • Accident victims when covered by employers' liability insurance

  • People with co-payment exemption after reaching their burden limit

The burden limit:

  • Standard: 2% of gross family income per year

  • Chronically ill: 1% of gross family income per year

Once you reach this limit, you can apply for exemption from your health insurance. Then you pay no co-payments for the rest of the year.


Special Case: Physical Therapy Costs for the Unemployed in Germany

Unemployed and need physical therapy? The key information upfront: You pay the same co-payment as everyone else (€10 prescription fee + 10% of treatment costs). Unemployment alone doesn't automatically exempt you from co-payments.

But: The good news is you'll reach your burden limit much faster:

ALG I recipients (unemployment benefit):

  • Burden limit: 2% of your annual income

  • With €1,200 ALG I monthly = only about €288 burden limit per year

  • You often reach this with just 6-10 physical therapy prescriptions

Bürgergeld/social welfare recipients:

  • Fixed burden limit: €135.12 per year

  • Chronically ill: only €67.56 per year

  • Tip: You can pay this amount in full at the beginning of the year and receive an exemption certificate for the entire year

How to proceed:

  1. Collect receipts – every co-payment counts (physio, medication, hospital)

  2. Calculate burden limit – quickly reached with low income

  3. Apply for exemption – form available from your health insurance

  4. Chronically ill? – Get it certified, then only 1% burden limit applies

Practical example: You receive Bürgergeld and need regular physical therapy? Pay €135.12 to your health insurance in January. You'll be exempt from all co-payments for the entire year – no matter how many treatments you need.

Self-payers: What Does Physical Therapy Cost Without a Prescription in Germany?

Without an insurance prescription, you pay the full treatment costs yourself. Prices vary by practice and region, but typically range between €30 and €80 per session:

Price overview for common treatments: 

  • Physical therapy (20 min): €30–55

  • Manual therapy (20 min): €40–65

  • Classic massage (15 min): €22–26

  • Classic massage (30 min): €30–45

  • Manual lymphatic drainage (30 min): €35–55

  • Neurological treatment (PNF, Vojta, 20 min): approx. €45–75

  • House call: €20–35 flat fee plus travel costs

Private insurance holders bill according to their individual plan. Prices are often similar, sometimes slightly lower than pure self-payer rates.

Additional Costs: What Extra Expenses Might I Face?

Beyond the actual treatment, additional costs may arise:

Non-reimbursable services: 

  • Osteopathy, chiropractic, or acupuncture (usually not covered by statutory insurance)

  • Shockwave therapy • Special wellness treatments

Materials and aids:

  • Kinesio tapes

  • Special bandages

  • Exercise equipment for home use

  • Therapy balls or bands

Other possible costs:

  • Travel costs for house calls (according to fee schedule or practice agreement)

  • Additional appointments without new prescription

  • Individual health services (IGeL)

Tip: Clarify potential additional costs with your therapist in advance. Many practices offer discounted package prices for self-payers.

Price Increase: New Physical Therapy Prices from April 2025 – What's Changing?

Reimbursement rates for physical therapy in Germany increase by 4.01% on April 1, 2025. This means:

  • Health insurance pays more per session

  • Your 10% co-payment increases minimally (a few cents per treatment)

  • The €10 prescription fee remains unchanged

Transition period April–June 2025: There was even a temporary 8.02% increase to compensate for delays. From July, the regular rate of 4.01% increase applies.

For self-payers, practice prices may adjust accordingly. The increase remains moderate – expect €1–3 more per session.

Special Case: Physical Therapy for Dogs – Costs and Coverage

Dogs can also benefit from physical therapy – especially after surgery, with arthritis, or neurological problems. Key facts:

  • Not covered by health insurance: Your health insurance only pays for you, not your pet

  • Costs: €40–70 per session (similar to human rates)

  • Special treatments: Underwater treadmill etc. can be more expensive

  • Reimbursement: Only possible through private pet health insurance

Cancellation Fee: What Happens If I Miss My Appointment?

Missed your appointment? That can be expensive. Physiotherapists in Germany may charge a cancellation fee for no-shows (§ 615 BGB):

The rules:

  • For short-notice cancellation or no-show: up to 100% of the treatment price

  • Many practices have their own policies (50–100% depending on notice period)

  • Cancellation fees may also apply for extreme lateness

How to avoid costs:

  • Cancel appointments at least 24–48 hours in advance

  • Inform the practice immediately if you're sick

  • Agree on clear cancellation rules at your first appointment

Important: You have no right to make up the missed appointment. You must pay the cancellation fee yourself – insurance won't cover it.

Prescription Requirement: Do I Need a Prescription for physical therapy in Germany?

Yes, for insurance coverage you absolutely need a medical prescription (Heilmittelverordnung). Without a prescription, you must pay for the entire treatment yourself.

Prescription details: 

  • Your GP or specialist issues the prescription

  • It includes diagnosis, treatment type, and number of sessions 

  • You only pay the €10 prescription fee once per prescription

  • For follow-up prescriptions for the same diagnosis, the prescription fee is waived

Tip for privately insured: Clarify with your insurance in advance whether and to what extent physical therapy is covered. Some plans require prior notification.

Direct Access: Physical Therapy Without a Prescription – Is It Possible in Germany?

Want to start physical therapy immediately without seeing a doctor first? In Germany, this is only possible under certain conditions.

The legal situation: physical therapy is considered medical treatment. Regular physiotherapists cannot treat illnesses without a doctor's prescription – that would be illegal. But there's an exception: the sectoral alternative practitioner for physical therapy (sektoraler Heilpraktiker für Physiotherapie, sHP-PT).

Your options without prescription:

1. Sectoral Alternative Practitioner physical therapy 

  • Physiotherapist with additional alternative practitioner license

  • May diagnose and treat independently

  • Costs: €35–70 per session (purely private service)

  • Initial assessment often €50–70 additional

  • Health insurance does NOT pay – not even partially

2. Wellness and Prevention 

  • Pure relaxation massages or prevention courses 

  • No treatment of illnesses • Costs: €30–60 per session

  • Prevention courses under § 20 SGB V: Insurance often reimburses 80%

Decision guide: Prescription or direct access?

Direct access via sHP-PT makes sense when: 

  • You have acute complaints and need immediate help

  • The wait for a doctor's appointment is too long

  • You're willing to pay €200–300 yourself

  • Your private insurance covers alternative practitioner services

Better see a doctor first when: 

  • Your budget is under €150

  • You have chronic or complex complaints

  • Red flags are present (severe pain, numbness, after accident)

  • You need a sick note

Important: The politically discussed "direct access" for all physiotherapists hasn't been implemented as of 2025. Pilot projects are running, but nationwide introduction is still pending.

Bottom line: physical therapy costs in Germany are quite predictable. With a prescription, your expenses remain manageable – expect about €3–5 per session plus a one-time €10 prescription fee. Without a prescription, it's significantly more expensive, but prices are still fair. What's important is not to postpone your treatment due to cost concerns. Talk to your doctor about a prescription and use the insurance benefits you're entitled to.

Quick Overview: Physical Therapy Costs in Germany at a Glance

Treatment Path

Your Costs

Advantages

Disadvantages

With insurance prescription

€10 prescription fee + approx. €3-5 per session

Affordable, quality assured

Waiting time for doctor appointment

With private prescription

€30-80 per session

Medical assessment available

Full costs self-paid

Direct access (sHP-PT)

€35-70 per session + initial assessment

Start immediately, no doctor needed

No insurance reimbursement

Wellness/Prevention

€30-60 per session

Uncomplicated, no waiting time

No illness treatment



Money-Saving Tips: How to Reduce Your Physical Therapy Costs in Germany

1. Don't forget your tax return You can deduct physical therapy costs as extraordinary expenses (außergewöhnliche Belastungen). Collect all receipts – co-payments count too! The reasonable burden ranges from 1-7% of your annual income depending on your tax bracket.

2. Use prevention courses Back school, Pilates, or yoga as prevention courses under § 20 SGB V: Health insurance often reimburses 80% of costs (up to €150 per course). You can usually use two courses per year.

3. Health insurance bonus programs Many insurers reward health-conscious behavior. Regular check-ups, exercise, or non-smoking earn points – redeemable as subsidies for health services.

4. Optimize prescriptions:

Get the maximum number of sessions prescribed to minimize prescription fees 

  • Use all prescribed appointments – expired sessions you'll have to pay for yourself later 

  • For long-term therapy: Ask about "prescriptions outside standard care" (Verordnung außerhalb des Regelfalls)

5. Compare prices As a self-payer, price comparison pays off. Some practices offer: 

  • Volume discounts for 10-session packages

  • Reduced rates for off-peak hours (early morning/late evening)

  • Student rates or social rates

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