Treats movement and musculoskeletal disorders through manual therapy and exercise. Regulated and licensed, but paid markedly less than the diagnostic professions.
| Official title | Physiotherapeut/in |
| Protected title | Yes — Masseur- und Physiotherapeutengesetz (MPhG) |
| Category | healthcare |
| Typical qualification | Ausbildung, 3 years, state exam (or Bachelor) |
| Regulated | Yes — state licence required |
| Last reviewed | 2026-09 |
What the job involves
Assessment and treatment of patients referred by a doctor: manual therapy, exercise therapy, gait and posture work, post-operative rehabilitation, neurological rehabilitation, respiratory physiotherapy. Settings range from private practices and rehabilitation clinics to hospitals, sports clubs and home visits.
No direct access. Treatment under statutory insurance requires a doctor’s prescription (Heilmittelverordnung), which also dictates the number and duration of sessions. Direktzugang has been debated for over a decade without being enacted.
Qualification route
- 3 years at a Physiotherapieschule, theory plus clinical placements, ending in a state exam
- Entry: mittlerer Schulabschluss
- Fees are the sore point. Unlike nursing and MT, physiotherapy training was not swept up by the recent reforms. Many schools are private and still charge tuition — commonly €300–500/month. Public and hospital-attached schools are free but heavily oversubscribed.
- Bachelor route (often dual, 3.5–4 years) exists and leads to the same licence.
A reform toward full academisation (Vollakademisierung) of the therapy professions has been announced repeatedly. Verify its current state before relying on anything here.
Pay
The weak point of the profession, and the reason for chronic attrition. Gross monthly, 2026. Only the public-sector row is tariff-verified (TVöD VKA, valid 01.05.2026 – 31.03.2027); the private-practice figures are market estimates:
| Setting | Gross/month |
|---|---|
| Private practice, newly qualified | €2,600 – €3,000 |
| Private practice, experienced | €3,000 – €3,600 |
| Hospital / public sector (TVöD EG 7–9a) | €3,295 – €4,980 |
| Self-employed practice owner | Highly variable; depends on private-pay share |
Public-sector employment pays better than private practice, which is the reverse of what many applicants assume. Earnings improve substantially with certified specialisations — Manuelle Therapie, Bobath, Lymphdrainage, KG-Gerät — because these unlock higher billing positions. Employers often part-fund them; get that in writing.
Foreign-trained candidates
- Apply for Anerkennung to the Bundesland authority (Landesprüfungsamt or equivalent).
- Gleichwertigkeitsprüfung, then an Anpassungslehrgang or Kenntnisprüfung to close gaps. Foreign physiotherapy degrees are frequently found broader than German training in assessment and narrower in the specific German manual-therapy canon.
- Language: B2 is standard.
- Visa: §16d AufenthG, or the skilled-worker route post-licence. Be aware that physiotherapy salaries sit below the EU Blue Card threshold, so the Blue Card is generally not available — you use the ordinary skilled-worker permit instead.
Pitfalls
- Salary expectations. Physiotherapists from the UK, Australia or the Nordics routinely find German pay lower than they anticipated relative to cost of living.
- Tuition fees at private schools catch people who assumed German vocational training is always free. It is not, in this profession.
- The certificate treadmill: without Manuelle Therapie and similar certifications your earning ceiling is low, and the courses cost thousands and take years.
- Prescription-bound practice frustrates clinicians used to autonomous assessment.
Sources
- Masseur- und Physiotherapeutengesetz (MPhG) — gesetze-im-internet.de/mphg, accessed 2026-09
- Anerkennung in Deutschland — anerkennung-in-deutschland.de, accessed 2026-09
- BERUFENET — berufenet.arbeitsagentur.de, accessed 2026-09