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What is the cost of treatment with a self-employed psychiatrist?

Receiving treatment from a medical specialist involves costs, and this is no different when consulting an self-employed psychiatrist in a private practice. If your GP refers you to a psychiatrist, the care provided is covered under the 'basic package' (basisverzekering) of your health insurance. This makes the treatment eligible for reimbursement. The exact reimbursement amount and whether you need to pay a personal contribution depend on several factors.

  • Contracts                 

    If the healthcare provider has a contract with your health insurer, the financial arrangements for your care are handled directly. The provider submits the claim for the services delivered directly to your insurer. You will receive a notification from your insurer, and the amount will be deducted from your excess (deductible).

  • No contracts            

    If your healthcare provider does not have a contract with your health insurer, you will receive the invoice for your treatment costs directly. Submit the invoice to your insurer to request reimbursement. Typically, you will receive reimbursement within 10 working days. You can then pay the provider without having to advance the payment yourself. The amount reimbursed will depend on the provider's rates and your insurance policy. From 2025 onwards, you will always be required to pay a personal contribution for care from non-contracted mental healthcare providers.

  • Health insurance    

    As mentioned above under 'No-contracts', the reimbursement you receive depends on the type of health insurance policy you choose. You will always be responsible for paying your excess/deductible. From 2025, health insurers will no longer offer full-reimbursement policies. If you had a full-reimbursement policy in 2024 ('restitutiepolis)' and had already started treatment, a transitional arrangement may apply. With a standard (natura) or combination (combinatie) insurance policy, reimbursements typically range from 50% to 75% of the NZa tariff (see Table 1 on this page). For more information about choosing a health insurance policy, please continue reading here .

  • Deductible/excess    

    The excess is the amount you are required to pay out of pocket for healthcare costs before your health insurer starts covering your expenses. This applies to almost all care covered by the basic insurance, including hospital treatments, medications, and treatment by an independent psychiatrist. The excess is paid annually, and only after you have paid this amount will your insurer begin to cover further costs (either fully or partially).

    For example, if your excess is €385 and you receive medical treatment costing €500, you will first pay €385 yourself. Depending on your insurance policy, the remaining €115 will be reimbursed either fully or partially by your health insurer.

    The excess does not apply to all types of care. For instance, visits to your GP, maternity care, and some other specific services are exempt from the excess.

  • Zorgtoeslag                

    You may be eligible for 'zorgtoeslag' (healthcare allowance), a government subsidy designed to reduce the cost of your health insurance. To qualify, you must have Dutch health insurance, and your income must not exceed certain thresholds. Always check your eligibility by performing a calculation on the Dutch Tax Office website.

  • Hinderpaalcriterium

    From 2025 onwards, full-reimbursement policies (restitutiepolis) will no longer be available. This means you will pay a portion of your healthcare costs yourself.

    This personal contribution arises because the reimbursement from your health insurer is lower than the rate charged by the healthcare provider. As a result, some patients may find it difficult to access care from non-contracted providers if they cannot afford the additional costs.

    What can you do?
    According to the hinderpaalcriterium (hindrance criterion), low reimbursement rates should not restrict your freedom to choose a healthcare provider. If the personal contribution is too high and this prevents you from accessing the care you need, you can request a higher reimbursement from your health insurer.

    Contact your insurer to ask about the hindrance criterion. An example letter that you can use to try appeal to it is available on this website. This could help you access the care you require.

  • Tax deduction           

    If you are required to pay a personal contribution for healthcare treatment with a self-employed psychiatrist, these costs may be tax-deductible under certain conditions.

    • It is important to note that there is a threshold amount for claiming healthcare costs as a tax deduction. Only the portion of costs exceeding this threshold is tax deductible. The threshold depends on your income and whether you have a fiscal partner.
    • Only specific healthcare costs that are not reimbursed and do not fall under your excess may qualify for this tax deduction. However, you can include all eligible medical expenses in the calculation, including those of your fiscal partner and children under 27.
    • Even if you have a low income and pay little or no taxes due to the deduction of healthcare costs, it can still be worthwhile to file a tax return. You may be eligible for a healthcare allowance.

    Although filing a tax return is necessary to claim healthcare costs as a deduction, it may be the most financially beneficial option for you.

Rates

Market-standard rates for mental healthcare are set annually by the Dutch Healthcare Authority (NZa). Table 1 provides the NZa-published rates for self-employed psychiatrists alongside reimbursements from various insurance policies. Table 2 presents links to the source documents describing the reimbursements from various insurance policies. If you are consulting a psychologist or another mental healthcare provider, refer to the rate finder to find the rates for different professions.

The descriptions accompanying the tariffs distinguish between consultations for 'diagnostics' and 'treatment' and show different time blocks for direct interaction between the provider and the patient. Additionally, the table includes 'other services' and 'surcharges' that may be charged. All ZGP tariffs since the introduction of the 'zorgprestatiemodel' are included in the table. The data can be filtered by criteria such as year, type of consultation, other services, or surcharges.

The healthcare invoice is calculated based on this tariff table and the actual direct time spent between the provider and the patient. This may create the impression that the declared tariff reflects the psychiatrist’s full income. However, the NZa tariff covers all costs incurred by the provider, such as:

  • Income
  • Indirect time—such as time spent on record-keeping, writing (referral) letters, and researching the best approach to your health issues
  • Premises/rental costs for the practice
  • Electronic health records, secure e-mail systems, website, and other software
  • Insurance (medical liability, disability, and legal insurance)
  • Additional diagnostics (e.g., laboratory tests or genetic profiling)
  • Pension contributions
  • Quality assurance (IFMS, re-registration, quality statute)
  • Professional memberships, continuing education, and peer review
  • Financial administration, reporting, and accounting services
  • Investments (furnishings, computer equipment, medical devices, business location)
  • A financial reserve equivalent to 6–12 months’ turnover (to cover periods not insured by disability insurance, uncovered legal costs, and unforeseen circumstances)

In summary, the rates encompass all costs associated with running the practice of an self-employed psychiatrist.

Rates and reimbursements

The rates in the table below originate from the publication dated 21 November 2024. The reimbursements apply exclusively to 2025. Currently, no reimbursements have been published by healthcare insurers Menzis and VGZ.

Table 1: Market-standard rates for mental healthcare set by the Dutch Healthcare Authority (NZa)

Table 2: Market-rates 2025 + reimbursements from health insurance policies

Disclaimer

While the figures in the tables above have been compiled with care, no rights can be derived from them. The rates published by the Dutch Healthcare Authority (NZa) and the reimbursement tables published by health insurers on their own websites are always decisive. Please note: Table 2 does not describe reimbursement policies from health insurer Menzis, as it has not yet made data available on its website. Additional terms and conditions may apply to treatment with a non-contracted healthcare provider. Always carefully review your insurance policy terms or contact your insurer’s customer service for clarification.

Is there a fee for missing an appointment?

Many self-employed psychiatrists apply a 'no-show' fee to minimise the loss of valuable time, particularly as there are many people on waiting lists for mental healthcare. The amount of the 'no-show' fee and the conditions under which it is charged are not regulated by the government. It is advisable to check with your healthcare provider for specific details regarding their policy.

Please note: A 'no-show' fee is not covered by your health insurer, as it does not qualify as a healthcare expense.

Can a self-employed psychiatrist provide an accurate estimate of the cost of my healthcare treatment in advance?

Since each individual’s care needs vary and costs are calculated based on the actual time spent, it is important to understand that your specific requirements will determine the final cost. As a result, it is not possible to provide an exact estimate of treatment costs in advance. However, you can contact your health insurer to inquire about the percentage or amount of the NZa tariffs that will be reimbursed (also see Table 1). This can give you some insight into the potential costs before starting treatment.