The Basics: Do I Need a Prescription for Physical Therapy in Germany?
Yes, in Germany you typically need a doctor's prescription for physical therapy. Physical therapy is classified as a medical remedy ("Heilmittel") and health insurance only covers it with a medical prescription.
After a thorough examination, your doctor decides whether physical therapy makes sense for your condition. This could be muscle tension, joint pain, back problems, or mobility issues after injuries.
The only exception: You can go to physical therapy without a prescription as a self-pay patient. But then you'll cover all costs yourself – which can get expensive fast.
Who Can Prescribe: Which Doctors Can Give Me Physical Therapy?
Several types of doctors can prescribe physical therapy:
Family doctors (general practitioners): Usually your first stop and can prescribe all types of physical therapy
Specialists: Orthopedists, surgeons, neurologists, internists – depending on your condition
Other specialists: Even dentists (for jaw joint problems) or ENT doctors can prescribe physical therapy
Hospital doctors: As part of discharge planning, they can issue prescriptions for post-hospital care
Tip: Not sure which doctor to see? Start with your family doctor – they can refer you to a specialist if needed or prescribe directly.
Prescription Details: What's on My Physical Therapy Prescription?
A physical therapy prescription contains lots of important information. Here's what to look for:
Personal Information:
Name, address, insurance number
Health insurance details
Type of Prescription:
EV = Initial prescription (first treatment for this diagnosis)
FV = Follow-up prescription (continuation of previous treatment)
V.a.d.R. = Prescription outside standard care (more sessions than usual)
Diagnosis Information:
ICD-10 code or brief diagnosis
Diagnosis group (e.g., WS for spine, EX for extremities)
Primary symptoms (letters A, B, C for different main complaints)
Prescribed Treatment:
Therapy type with abbreviations (KG, MT, MLD etc.)
Number of sessions (e.g., 6x)
Session duration (e.g., 20 min)
Additional treatments (heat, cold, electrotherapy)
Timing Details:
Issue date
Treatment frequency (e.g., 1-3x per week)
"Urgent" notation if applicable
Important: Without doctor's stamp and signature, the prescription is invalid!
Deadlines: How Long Is a Physical Therapy Prescription Valid?
The deadlines are crucial – miss them and your prescription expires:
Starting Treatment:
Normal case: Within 28 days of issue date
Marked urgent: Within 14 days
After hospital discharge: Within 7 days
Treatment Duration:
Up to 6 sessions: 3 months to complete
More than 6 sessions: 6 months to complete
Workers' comp prescriptions: Usually only 2 months
Interruptions:
Maximum 14-day break allowed
For longer breaks: Have reason noted on prescription
Otherwise insurance may stop coverage
Private insurance: Often has different rules – check deadlines with your insurer.
Deadline Checklist
□ Check issue date
□ Calculate deadline for starting treatment
□ Schedule appointments regularly
□ For interruptions: Inform therapist
What Happens If My Prescription Expires?
Prescription expired: Once the deadline passes, the prescription becomes invalid. You'll need to:
Go back to your doctor
Explain the situation
Request a new prescription
Treatment stopped early: If you don't use all prescribed sessions, the remaining ones are forfeited. No big deal – just talk openly with your doctor about it.
Need a new prescription: After a break or when all sessions are used up, you can get a follow-up prescription if needed. Your doctor decides whether further treatment makes sense.
Don't panic: Doctors know these situations happen. An expired prescription can usually be reissued without problems.
Treatment Scope: How Many Sessions Do I Get?
The number of treatments depends on your diagnosis:
Standard: Usually 6 sessions of 15-30 minutes each
If needed: 10 or 12 sessions possible
Maximum amount: The remedy catalog sets limits for each diagnosis
Special case V.a.d.R.: With medical justification, more sessions can be prescribed
Treatment frequency:
Acute issues: Often 2-3x per week
Chronic problems: Usually 1-2x per week
After surgery: Can be daily
After using all sessions: Often you need to wait 6 months before getting a new prescription for the same diagnosis. Exceptions possible for special needs.
Follow-up Care: When Do I Need Another Prescription?
Follow-up prescription (FV): When you need more therapy after the first series, your doctor issues a follow-up prescription. It builds on the previous treatment.
Prescription outside standard care (V.a.d.R.):
More sessions than normally allowed
Requires special medical justification
Enables longer treatment series without interruption
When to see your doctor for follow-up:
Before current treatment ends
If symptoms persist
When you realize the prescribed sessions won't be enough
Joint decision: Discuss with your doctor how to proceed after initial treatments. They can assess whether more therapy makes sense.
Multiple Prescriptions: Can I Get Two Prescriptions at Once?
Basic rule: Usually only one prescription per diagnosis at a time.
Possible exceptions:
Different diagnoses: For different problems (e.g., back AND knee), two prescriptions are theoretically possible
Combination prescription: Often different therapy types are combined on one prescription (e.g., PT plus heat therapy)
In practice: Usually you wait for the first prescription to end before getting another. That's the standard approach.
Questions? Talk openly with your doctor if you think two parallel treatments are necessary. They'll explain your options.
Abbreviations: What Do the Codes on My Prescription Mean?
You'll find various abbreviations for prescribed therapies on your prescription. Here's the overview:
Main Therapies
Code | Full Name | When It's Used |
KG | Physical Therapy Exercises | General movement therapy for pain, mobility issues, after surgery |
KGG | Equipment-Based Training | Targeted muscle building and strength training on therapy equipment |
MT | Manual Therapy | Joint blockages, spine problems, limited mobility |
KMT | Classic Massage Therapy | Muscle tension, hardening, circulation problems |
MLD | Manual Lymph Drainage | Lymphedema, swelling after surgery or injuries |
Additional Treatments
Code | Full Name | When It's Used |
Elektro | Electrotherapy | Pain relief, muscle stimulation, circulation improvement |
US | Ultrasound Therapy | Deep heat for tendon and joint problems |
Kryo | Cryotherapy (Cold) | Acute injuries, swelling, inflammation |
Thermo | Thermotherapy (Heat) | Muscle tension, chronic pain |
Special Treatment Concepts
Code | Full Name | When It's Used |
BOB | Bobath Therapy | Neurological conditions (stroke, MS, Parkinson's) |
PNF | Proprioceptive Neuromuscular Facilitation | Coordination disorders, neurological deficits |
FBL | Functional Movement Training | Posture problems, functional disorders |
CMD | Craniomandibular Dysfunction | Jaw joint problems, teeth grinding |
Time Specifications for Lymph Drainage
Code | Meaning | Application |
MLD-30 | 30-minute lymph drainage | Light edema, single body regions |
MLD-45 | 45-minute lymph drainage | Moderate edema, multiple regions |
MLD-60 | 60-minute lymph drainage | Severe edema, full body treatment |
Tip: Unsure what an abbreviation means? Just ask your therapist – they'll gladly explain what treatment it involves and how it works. Here you can find our fill-in guide.
Treatment Types: What's the Difference Between KG and MT?
Physical Therapy Exercises (KG):
General movement therapy
Exercises for strength, mobility, coordination
Any physical therapist can provide KG
Broad range of applications
Manual Therapy (MT):
Special hands-on techniques
Especially for joint blockages and spine problems
Therapist needs 2-year additional training
Targeted joint mobilization
In practice: Often both approaches are combined. The main difference is the therapist's additional qualification and techniques used.
What matters for you: Trust your therapist – whether KG or MT was prescribed, the treatment will be tailored to your condition.
Diagnosis Groups: What Do EX, WS, ZN Mean on My Prescription?
Diagnosis groups categorize your condition:
WS = Spine disorders (back, neck)
EX = Extremities (arms, legs, shoulder, knee)
ZN = Central neurological disorders (e.g., after stroke)
AT = Respiratory conditions • SO = Other conditions
Primary symptoms (A, B, C...):
Describe your main problem more specifically
A = often pain
B = often movement restriction
C = often muscle weakness
Why this matters: These codes help the therapist choose the right treatment. You don't need to know the details – just that your condition was properly categorized.
Special Case: What's a Workers' Comp Prescription?
BG prescription = Workers' Compensation prescription
When you get one:
After a workplace accident
After a commuting accident (to/from work)
For occupational diseases
How to recognize it:
Usually yellow prescription (instead of pink)
Marked "BG" or "Work Accident"
Issued by authorized accident doctor
Your advantages:
No copayment
All costs covered by workers' compensation
Often more intensive treatment possible
Special rules:
Start treatment within 14 days
Complete treatment usually within 2 months
Close monitoring by workers' comp
Important: Report any workplace accident to your employer immediately and get referred to an authorized accident doctor!
Final Tip
A physical therapy prescription isn't rocket science. Watch the deadlines, keep your appointments regularly, and communicate openly with your doctor and therapist. When in doubt, just ask – that's what the experts are there for. Your health is the priority, and with the right knowledge, you can make the most of your therapy.
