Referral, costs and waiting times

Legal status: 09.10.2026 (German federal law SGB V, checked against the statutory text; for people with statutory health insurance). This article makes no statement on private health insurance, Beihilfe (civil-servant health benefits) and self-payment. The guideline (text version 2016) has expired. ^[6] This article describes the legal situation in Germany. Information on current waiting times: read on 23.10.2026.

Referral and free choice of doctor

The 2016 guideline stated that parents and patients in Germany have free choice of doctor and can, for example, contact child and adolescent psychiatric specialist clinics directly, without a special referral. ^{[5, Ch. B.1.1]} This describes the situation as of 2016. Individual facilities may have their own requirements, which you should ask about. Legally, people with statutory health insurance can choose freely among licensed doctors, medical care centres and authorised facilities; if you choose a service that is not the nearest one without a compelling reason, you bear the additional costs. ^{[2, para. 1, 2]}

Who bears the costs

People with statutory health insurance are entitled to medical treatment; this includes, among other things, medical treatment including psychotherapy if it is necessary to detect or cure an illness, prevent it from getting worse or alleviate symptoms. ^{[1, para. 1]} Outpatient assessment and treatment can take place, among other places, at licensed practices, at psychiatric outpatient clinics (hospitals authorised for insured people who depend on this treatment because of the nature, severity or duration of their illness) and, for children, at social paediatric centres. ^{[3, para. 1; 4, para. 1, 2]} Social paediatric centres are geared towards children who, because of the nature, severity or duration of their illness or an impending illness, cannot be treated by suitable doctors or at suitable early intervention services. ^{[4, para. 2]}

What we have not checked: co-payments, reimbursement at private practices, whether a particular health insurer covers the assessment at a particular service, and rules for cost coverage by other providers. Ask the service and your health insurer before the appointment.

Waiting times

The 2016 guideline mentioned long waiting times for assessment appointments at specialised services and additional waiting times for a suitable therapy offer, and called for establishing the earliest possible assessment. ^{[5, Ch. B.4.13.2]} It considered improving early, prompt and correct diagnosis in Germany to be urgently necessary (consensus-based, strong consensus). ^{[5, Rec. 6]} We have not read a nationwide statistic on waiting times.

Current information (read on 23.10.2026). The Federal Association autismus Deutschland writes that considerable waiting times of two years or more are to be expected in adult services, and that waiting lists are (as of 18.08.2026) almost everywhere closed or limited to regional catchment areas. ^[7] Individual hospitals state on their websites: LWL-Klinik Dortmund a waiting list of currently about four years with no new enquiries accepted, ^[8] University Hospital Freiburg at least three years between receipt of the questionnaires and the assessment appointment, with registration temporarily closed, ^[9] and Klinikum St. Georg Leipzig a waiting list closed until December 2028. ^[10] These examples say nothing about an average waiting time across Germany. The IQWiG health information (created in June 2024) names waiting times of sometimes more than one year. ^[11] A news item in German gives an overview of the situation: Meldung zu den Wartezeiten (in German).

In our collection of contact points, some facilities’ websites give information about admission: according to its page (read on 09.10.2026), an adult clinic at a university hospital stated that it is currently not giving appointments to new patients. Other facilities do not mention waiting times and costs on their page at all. So ask at each service.

Services where assessment is possible

You can find directories and facilities under the Contact points. A directory of several assessment services maintained by a private parents’ initiative is also linked there; according to the site, a directory entry is not proof of an assessment offer. For adults: Assessment in adulthood. For children: Diagnosis in children: who, where, how?.

What else you should know

• Questions for the first call (practical suggestion from the editorial team): Is a referral needed? Is there a waiting list, and how long is it? Which documents should I bring? Are there any costs? Are appointments given for children, adolescents or adults?
• In a dispute with the health insurer, objections and advice help: Applying and filing an objection and Understanding the support system.
• Not covered: appointment service centres, length of approval, private assessment and reimbursement of costs.

Sources and literature

1. § 27 SGB V – Krankenbehandlung (www.gesetze-im-internet.de/sgb_5/__27.html). – Statute (German federal law, in German)
2. § 76 SGB V – Freie Arztwahl (www.gesetze-im-internet.de/sgb_5/__76.html). – Statute (German federal law, in German)
3. § 118 SGB V – Psychiatrische Institutsambulanzen (www.gesetze-im-internet.de/sgb_5/__118.html). – Statute (German federal law, in German)
4. § 119 SGB V – Sozialpädiatrische Zentren (www.gesetze-im-internet.de/sgb_5/__119.html). – Statute (German federal law, in German)
5. DGKJP, DGPPN et al. Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter. Teil 1: Diagnostik. S3-Leitlinie, AWMF-Reg.-Nr. 028-018, Textstand 23.02.2016 (Kap. B.1.1, B.4.13.2; Empf. 6). – Guideline (in German) (expired; according to the document note under revision)
6. DGKJP. Aktuelle Leitlinien (Eintrag 028-018: „Gültig bis 04.04.2021“). https://www.dgkjp.de/wissen/aktuelle-leitlinien/ – Professional society (website in German)
7. Bundesverband autismus Deutschland e.V.: Aktuelle Situation zur Autismusdiagnostik in Deutschland, Stand August 2026 (www.autismus.de/autismus/diagnostik.html). Retrieved 23.10.2026 – Professional association (in German)
8. LWL-Klinik Dortmund: Autismus-Ambulanz (www.lwl-klinik-dortmund.de/de/ambulanzen/autismus-ambulanz/). Retrieved 23.10.2026 – Facility website (in German)
9. Universitätsklinikum Freiburg: Spezialsprechstunde für Autismus im Erwachsenenalter (www.uniklinik-freiburg.de/psych/ambulanzen-uebersicht/ambulanzen/autismus-spektrum-stoerungen.html). Retrieved 23.10.2026 – Facility website (in German)
10. Klinikum St. Georg Leipzig: Autismus-Diagnostik für Erwachsene (www.sanktgeorg.de/patienten-besucher/verbund-gemeindenahe-psychiatrie/autismus-diagnostik-fuer-erwachsene.html). Retrieved 23.10.2026 – Facility website (in German)
11. IQWiG, Gesundheitsinformation.de: Wie wird Autismus festgestellt? Created 19.06.2024 (www.gesundheitsinformation.de/wie-wird-autismus-festgestellt.html). Retrieved 23.10.2026 – Health information (in German)