DPH psychoterapie: Co je to a jak to ovlivňuje cenu terapie v ČR

When you pay for therapy in the Czech Republic, part of that money goes to DPH, daň z přidané hodnoty, kterou musí terapeuti splácet státu. Also known as daň z přidané hodnoty, it is a tax applied to most professional services, including psychotherapy, even though it’s a health-related field. Unlike medical doctors, psychotherapists in the Czech Republic are not exempt from this tax, and that directly affects what you pay for each session. This isn’t a hidden fee—it’s baked into the price you see on the therapist’s website or invoice. And yes, it’s one of the main reasons why therapy costs between 500 and 1,400 Kč per hour, even though health insurance only covers around 500 Kč.

Therapists in the Czech Republic must register as self-employed entrepreneurs, and once their annual income crosses the threshold (currently 1 million Kč), they’re legally required to charge DPH. Many therapists charge it even before reaching that limit, simply because it’s easier to manage administratively. So when you pay 1,200 Kč for a session, roughly 220 Kč of that is DPH—money that goes straight to the state, not to the therapist’s pocket. That’s why a therapist who charges 1,200 Kč doesn’t actually earn 1,200 Kč—they earn closer to 980 Kč after taxes and expenses like rent, software, training, and supervision. This is rarely explained to clients, but it’s critical to understand if you’re wondering why therapy feels so expensive.

It’s not just about DPH, though. The real issue is the mismatch between what the system pays and what it costs to deliver quality care. Health insurance companies reimburse therapists at a fixed rate of 500 Kč per session, regardless of the therapist’s experience or the complexity of the case. That means if you’re paying 1,200 Kč out of pocket, you’re covering not just the therapist’s time, but also the gap left by the insurance system. Many therapists who accept insurance end up losing money per session, which is why so many choose to work privately. If you’re paying full price, you’re not just funding therapy—you’re funding a system that doesn’t fully support it.

There’s also a big difference between psycholog, osoba s vysokoškolským vzděláním v psychologii, která může poskytovat poradenství, ale ne psychoterapii. Also known as psychologický poradce, it is a professional who helps with life challenges but cannot legally provide therapy under the Czech health law and a psychoterapeut, osoba s atestací a dlouhodobým výcvikem, která má právo provádět psychoterapii jako zdravotnickou službu. Also known as atestační psychoterapeut, it is a legally recognized provider of clinical psychological treatment. Only the latter can be called a psychoterapeut, and only they can legally charge for therapy as a medical service. Many people confuse the two, and some unqualified providers charge therapy prices without the proper training. Always check for the official atestace—your safety and progress depend on it.

So what can you do? If you’re on a tight budget, look for low-cost options through universities, non-profits, or online platforms that offer sliding scales. Some therapists offer reduced rates for students or people with low income. You can also ask if they accept payment plans. But don’t settle for someone who doesn’t have proper credentials just because they’re cheaper. Quality therapy isn’t a luxury—it’s a necessity, and you deserve to get it from someone who’s qualified. The DPH might be frustrating, but it’s not the root problem. The real issue is that society still doesn’t treat mental health like physical health—and until that changes, you’ll keep paying more to get the care you need.

Below you’ll find articles that break down exactly how therapy pricing works in the Czech Republic, what you’re actually paying for, and how to find help that fits your budget without sacrificing quality.