Protests erupt in Erfurt as psychotherapy fee cuts spark outrage across Germany
Mental Health Crisis Deepens as Psychotherapy Fees Face Cuts
ERFURT—Depression, anxiety disorders, obsessive-compulsive disorder: mental illness has been on the rise for years. Now, plans to slash fees for psychotherapists—the very professionals treating these conditions—have sparked outrage.
On Saturday, therapists and patients gathered in Erfurt to protest looming cuts to psychotherapy reimbursement rates. Around 150 demonstrators assembled outside the state parliament, according to a police spokesperson. The move comes after a decision by Germany's Extended Evaluation Committee—a federal body representing health insurers and medical professionals—to reduce fees for outpatient psychotherapy by 4.5 percent starting in April.
The committee approved the cut two weeks ago, overruling objections from doctors' and psychotherapists' representatives. Insurers justified the measure by arguing that self-employed psychotherapists in private practice have received "disproportionately high" fee increases in recent years.
In Thuringia alone, 586 psychotherapists currently provide outpatient care, treating conditions such as depression, anxiety, obsessive-compulsive, and eating disorders, according to the state's Association of Statutory Health Insurance Physicians. Common treatment methods include cognitive behavioral therapy and psychodynamic therapy.
While the number of therapists has steadily grown—rising from 457 in 2019—patients still face long waits for appointments. Beyond surging demand, structural differences set psychotherapy apart from physical healthcare. Patients typically attend one to two sessions per week over a fixed period, with prior approval from their insurer. Depending on the treatment approach, a full course may require 24 to 100 sessions, sometimes more. Only once a patient completes therapy can a new one begin treatment.
Data from the Association's 2024 fee report shows that statutory health insurers paid nearly €74.7 million gross for outpatient psychotherapy in Thuringia last year—just a fraction of the €1.3 billion total spent on all primary care and specialist physicians. Meanwhile, the decision to cut psychotherapy fees has triggered nationwide protests.
