At a glance
Practice decides
Medical necessity is assessed individually.
Muster 4
The prescription records details of the planned patient transport.
Clarifications
Clarify prior approval and cost questions in good time.
What is a German "Transportschein"?
In everyday German, "Transportschein" usually means the prescription for patient transport on the form known as Muster 4. It records the medical decision about whether transport is necessary and which type is required, whether a medical ride, qualified patient transport or an ambulance (see the comparison of these transport types if the distinction is unclear).
According to the German National Association of Statutory Health Insurance Physicians (KBV), authorised physicians and certain psychotherapists can issue Muster 4; see psychotherapy rides in Berlin for an example of Muster 4 issued for that purpose.
How to obtain a prescription
- Discuss the need for transport with the treating practice before the journey.
- Describe the appointment, mobility needs and why suitable transport is required.
- The practice assesses medical necessity and the required type of transport.
- Clarify whether the health insurer must approve the prescription before the journey.
Patients do not choose the medical fields themselves and should not fill Muster 4 on their own.
What information is on Muster 4?
The form contains information about the treatment, reason for travel, type of transport and any required approval. It is completed for the individual case. The German Patient Transport Directive governs the requirements and selection; it does not replace advice from the practice or health insurer.
The practice completes the medical details. These include the correct insured-person data, the reason for transport, treatment day or frequency, the treatment facility and the suitable type of transport.
For PrimaFahrten, taxi/hire car is usually the relevant category; a wheelchair or carrying chair is added where needed for the journey. Patients should not enter doctor or facility numbers themselves and should not specify the medical selection.
The prescription can contain information on the co-payment. Outbound and return journeys are each assessed separately from a medical point of view. Journeys actually made are documented for billing and confirmed by the insured or entitled person; do not confirm journeys in advance that have not yet taken place.
Journeys to a spa cure or rehabilitation are not regulated through Muster 4 as the standard procedure. For a longer journey to or from rehabilitation, clarify approval with the responsible rehabilitation provider (see rehabilitation rides from Berlin).
Date, route, mobility aids and access to buildings must be provided in full, regardless of the form.
What to clarify before booking
- Is the prescription complete and valid for the appointment?
- Is prior approval required, and has it been obtained?
- Which mobility aid, wheelchair or building access must be considered?
- Who is the contact person for appointment changes?
A prescription is not an automatic cost commitment
A prescription alone does not always mean that all costs will be covered. The legal requirements and the payer's individual decision are decisive. Read our guide to cost coverage and co-payments. Which personal requirements, such as care level or disability marker, must also be met is described in care level and disability markers for medical rides.
Example from practice
For a treatment appointment that is needed regularly, the patient first discusses with the treating practice whether patient transport is medically necessary. The practice decides whether Muster 4 is issued and which type of transport is entered.
It is then checked whether the health insurer must approve before the first ride. When the health insurer must approve a ride in advance is explained in getting approval from the insurer.
Frequently asked questions
Who issues Muster 4?
Authorised physicians and certain psychotherapists, according to the KBV.
May I fill in the form myself?
No. The practice completes the medical details; patients should not fill Muster 4 on their own.
Does Muster 4 apply to the journey to rehabilitation?
Journeys to a spa cure or rehabilitation are not regulated through Muster 4 as the standard procedure. Clarify approval with the responsible rehabilitation provider.
Should I confirm rides in advance?
No. Do not confirm journeys that have not yet taken place.
By Tobias A. Kreuzig, co-founder of PrimaFahrten GmbH
Published: 27 July 2025 · Last substantive update: 26 October 2026
Sources and further information
German Federal Joint Committee: Patient Transport Directive · KBV: Patient transport
