German group basic care grows fast and its regulator cannot say why
- The document is a report by Germany's Federal Joint Committee (G-BA), dated 5 May 2026, evaluating group psychotherapeutic basic care (GPGV), a service in force since 18 February 2021. GPGV is up to four group sessions of 100 minutes for 3 to 9 patients, needs no notification, application or approval, and does not count against the guideline therapy quota. The data are statutory outpatient billing records from the fourth quarter of 2021 to the fourth quarter of 2024.
- The number of patients with at least one GPGV billing rose from 2,268 (2021/Q4) to 10,638 (2024/Q4), with one decline, 9,795 in 2024/Q3 (-4.0%). About 85% of patients were adults and about 15% children and adolescents. Most billings were for groups of five participants, and 44 to 46% of patients used the full 3.5 to 4 units.
- In the four quarters after their last GPGV session, almost 73% of patients in both cohorts (2022 and 2023) received guideline psychotherapy: 43% (2022) and 44.8% (2023) individual and group, 14.4% and 12.7% group only, and 15.1% and 15.2% individual only.
- G-BA writes that the descriptive analyses cannot show whether GPGV promotes the start of group therapy. No comparison was made with patients who did not receive GPGV, and other measures to promote group therapy were introduced in the same period.
The G-BA, which sets the rules for statutory health insurance in Germany, has published its five-year evaluation of group psychotherapeutic basic care (GPGV), a short introductory group that a psychotherapist can bill without asking the insurer for approval. The report concerns anyone who refers patients into the German system or runs groups there.
Use climbs, quarter by quarter
Patients with at least one GPGV billing rose from 2,268 in 2021/Q4 to 10,638 in 2024/Q4, with a dip to 9,795 in 2024/Q3. The number of therapists billing the service per quarter rose from 387 to 1,551. Groups of five were the most common.
After the group
Within four quarters of the last session, almost 73% of patients received guideline psychotherapy, mostly individual and group together (43% in the 2022 cohort, 44.8% in 2023). G-BA calls this compatible with the aim of easing access to group therapy. In the same paragraph it adds that the analysis cannot show whether GPGV favours starting group therapy: nobody was compared with patients without GPGV, and the billing data do not show which service came first within the index quarter.
Growth with no stated cause
The report names other measures that could have moved the numbers: the end of the report requirement for guideline therapy and a more flexible group size. The number of therapists authorised for group therapy also rose, from 13,149 in 2021 to 16,906 in 2024, and the pandemic reduced the groups offered. The report does not rank these against GPGV.
A format that is easy to bill and needs no approval can spread whether or not it changes anything for patients. Rising billing says the format became routine, not that patients reached groups they would otherwise have avoided. For a referrer the reading is narrow: GPGV is available, capped at four sessions, and a low-stakes trial for a client unsure about groups. It should not be offered as a preparation whose effect on entering group therapy has been shown.
G-BA's own reading of its figures: the descriptive analyses cannot show whether basic group care leads patients into group therapy.
The evaluation rests on billing data collected for payment, not for research, and covers quarters only. It has no control group and cannot show whether GPGV came before or after other therapy within the index quarter, so individual therapy may be overestimated. Billing codes can misclassify group size and units. Other measures promoting group therapy and the pandemic overlap with the observation period.