NRW psychotherapists strike back against looming pay cuts in 2026

Psychotherapists in North Rhine-Westphalia (NRW) are preparing to protest against planned pay cuts this Thursday. The demonstrations will take place in several cities, including Cologne, Düsseldorf, and Dortmund. The changes, set to begin in April 2026, have raised concerns about worsening access to mental healthcare across the state.

From 1 April 2026, health insurers will reduce reimbursement rates for psychotherapeutic services by 4.5%. The Psychotherapists' Chamber of NRW warns that this could push more therapists to prioritise private patients, who pay higher fees. Currently, statutory insurance patients in NRW already face an average five-month wait for an initial consultation.

Psychotherapists in Germany already earn less than any other specialised healthcare providers. The financial strain may worsen as securing a *Kassensitz*—a public health insurance licence—can cost up to €50,000. With around 7,000 of these licences missing nationwide, the shortage is making it harder to meet demand. The Bundespsychotherapeutenkammer has repeatedly called for more *Kassensitze* to address gaps in care. Its leaders stress that without intervention, waiting times will grow, and fewer therapists will remain in the statutory system.

The protests highlight fears that lower fees will drive therapists away from public insurance patients. If more shift to private practice, statutory patients could face even longer delays. The outcome may further strain a system already struggling with shortages and high costs.