How much does it cost to have a foreign nursing qualification recognized in Germany? Those who ask this question usually hear a range of several thousand euros, without any breakdown or source. Most federal states publish their fees, and they are listed. Some of them are fixed amounts, while others are ranges or guidelines.
They are nevertheless not comparable. One country charges a fee for the entire procedure, another separates equivalence determination and the certificate, and in a third country two different authorities are responsible for the two steps. Therefore, anyone comparing offers or locations must know what is included in the respective fee.
The most important in a nutshell
The federal states are responsible for recognition in the care professions, and each state has its own fee regulations. Therefore, the same examination costs something different in Düsseldorf than in Darmstadt.
In addition, there is a difference that often goes unnoticed in cost overviews: The countries charge their fees differently.
A number from one country cannot therefore be transferred to another, and two numbers from two countries are not easily comparable. Furthermore, individual expenses that are nevertheless incurred are not calculated by the authorities: the examination is usually taken by a nursing school, and an adaptation course is conducted by an educational institution.
What follows is a Selection of seven federal states and not a comparison of all sixteen. All amounts come from the official sources linked below and apply to a qualification from a third country.
| State | Equivalence | Permission or document | Together |
|---|---|---|---|
| Bavaria | 40 to 70 € | 40 € (Certificate) | 80 to 110 € |
| Rheinland-Pfalz | 50 to 300 € | 44 € | 94 to 344 € |
| Berlin | 164 € for the procedure in total | 164 € | |
| Hesse | 110 € (Item 1213) | 110 € (Item 1214) | 220 € |
| Lower Saxony | approx. 200 € | 53 € | approx. 253 € |
| North Rhine-Westphalia | 150 € according to the tariff rate, currently 112.50 to 350 € according to the authority | 60 €, with language test 80 € | 210 to 430 € |
| Baden-Württemberg | Usually 100 € | 250 € (Third country) | approx. 350 € |
Three notes regarding the use of this table.
First of all Several figures are formulated by the authorities themselves as guidelines, marked by „usually“, „approx.“ or „up to“. Bavaria and Rhineland-Palatinate list ranges, while North Rhine-Westphalia lists a maximum amount.
Secondly For qualifications from the EU, some other amounts apply. In Berlin, the automatic recognition costs 115 euros instead of 164, in Hesse 165 euros, in Baden-Württemberg 200 euros for the certificate instead of 250. In Lower Saxony, it costs around 60 euros for the determination of automatic equivalence, and the 53 euros for the permit certificate are added there, so they are not included.
Thirdly Several of these pages do not have an updated date of publication. For Berlin, Baden-Württemberg and Lower Saxony, it was not possible to determine when the amounts were last updated. Rhineland-Palatinate indicates April 2025, Bavaria July 2026, Hesse is based on a decree of February 13, 2026, announced on February 23, 2026, and in effect since March 9, 2026.
Berlin. The state's service portal also lists an amount of 85 euros. This applies exclusively to individuals who have passed the state examination in Berlin. It is not applicable to a qualification obtained abroad.
Hessen. Item 1211, with its 80 euros, concerns persons who are completing their education. in Germany Those who list this figure as the Hessian recognition fee for a foreign degree are significantly lower than the actual amount.
North Rhine-Westphalia deserves its own sales area because the process is divided into two locations there.
The Equivalence test It has been running nationwide since July 2021 centrally through the Central Recognition Authority for the Health Professions at the Münster District Government (Bezirksregierung Münster). There are two figures for the fee amount there, and the more recent one is the relevant one. The application form lists a maximum limit of up to 277.50 euros. The latest information from the authority continues: In the process, two fee notices are usually issued, which together usually range between 112.50 and 350.00 euros, because the fee is based on the specific administrative workload.
Münster also points out that in addition to the fee, expenses may be incurred, and that the fee also applies in part if the withdrawal or rejection is initiated after the processing has begun. The issuance of a conformity certificate, however, is free of charge.
The Permission to use the professional title In contrast, the district government of the place of residence issues the one for the planned place of work if the residence is abroad. For this, 60 euros are charged. The decision states which department is responsible in the individual case.
For the tariff offices in detail: 150 euros for the qualification examination upon establishment (12.1.3.2.1), 60 euros for the permit (12.1.3.1.1) or 80 euros, if a language test is also required (12.1.3.1.2), 20 euros for organizing a knowledge assessment component (12.1.3.2.4) and 37.50 to 87.50 euros for deciding after a successful settlement measure (12.1.3.2.5).
The higher permit amount of 80 euros depends on the language test, not on the origin of the degree. A third-country degree alone does not qualify you for it.
Which department in your federal state is responsible and how the procedure works is explained here: Recognition of foreign qualifications in Germany
If the competent authority cannot classify the foreign qualification on its own basis from the documents, it will commission a report from a qualified expert. Expert Committee for Health Professions (GfG). The GfG is a separate work area within the Central Office for Foreign Education (ZAB), It is a joint body of the Länder within the Conference of Ministers of Culture. It works on behalf of the recognition authorities, not for applicants, and therefore does not publish its own fee regulations.
The amounts are only found in the information provided by the countries, and they differ according to the type of the opinion.
| Type of opinion | Amount | published by |
|---|---|---|
| Authenticity and accuracy of the documents | 145,00 € | Münster District Government (Bezirksregierung Münster) |
| Determination of the reference qualification | 417,00 € | District government Münster, Rhineland-Palatinate |
| Contental assessment of equivalence | 515,00 € | Lower Saxony, Rhineland-Palatinate |
Three points to add to that. Whether a report is even necessary is decided on a case-by-case basis by the authority; this position is therefore subject to potential additional costs, and not a fixed amount. Both sources write „currently,“ without specifying a date, why the amount must be requested before planning. And the costs are borne by the applicant in addition to the administrative fee: Münster informs in advance and requires a signed declaration of acceptance of costs.
In addition, there is another additional charge for individual countries of origin. Münster points out that requests to foreign institutions, for example in Pakistan, India and Nepal, are subject to a fee, require advance payment and must be paid directly to the relevant institution, independent of the GfG fee.
If the authority identifies significant differences, an adjustment measure will be implemented. This ends the transparency of the fee regulations, as the examination is usually carried out by a nursing school and they themselves charge the fees.
In none of the audited Länderordnungen is the nursing knowledge examination included as a fee item. For example, the Hessian administrative cost list lists the state examination with 80 euros under number 1251, but explicitly refers to §§ 9, 19, 24, 39 and 40 PflAPrV, i.e., the regular final examination of German training. The knowledge examination according to § 45 PflAPrV is not mentioned there.
What the states charge is the administrative act surrounding it. In North Rhine-Westphalia, that is 20 euros per examination section for the Organization the knowledge test. That is not the price of the exam.
There is an official benchmark for the actual examination costs: The Hamburg Social Services Authority’s brochure on recognition exams under the Nursing Professions Act, as of May 2026, lists „usually about 300 €“ for the oral exam and „about 500 € for the practical exam“. Both amounts are marked with a specific entry in the brochure for May 2023, and the brochure recommends confirming the costs before the exam. As a rough estimate, they are not suitable as a current fixed price.
At/On/Upon Adaptation course Costs depend on the decision and the educational institution. A range cannot be given for this purpose in a reliable manner. This position is eligible for funding, see below.
In depth: nursing knowledge examination · recognition decisions identifying qualification gaps.
These amounts are regulated nationwide. Important for the assignment: They are no recognition fees, but fees for the right of residence, and they are charged to third-country nationals. This concerns Regular fees. Exemptions and discounts under §§ 48 ff. of the AufenthV remain possible in individual cases.
| Position | Legal basis | Fee |
|---|---|---|
| Accelerated skilled worker procedure | Section 47, paragraph 1, no. 15 of the AufenthV | 411,00 € |
| National visa | Section 46 of the AufenthV | 75,00 € |
| Extension of the national visa | Section 46 of the AufenthV | 25,00 € |
| Residence permit, issuance | § 45 AufenthV | 100,00 € |
| Residence permit, extension for three months | § 45 AufenthV | 93,00 € |
| Change of purpose of stay | § 45 AufenthV | 98,00 € |
The accelerated skilled worker procedure is voluntary. The 411 euros will also be charged if there is a rejection, and the procedure sets deadlines for individual sections, without guaranteeing a total duration until work begins. An adaptation course or an examination is not subject to these deadlines.
Nationals of the EU, the EEA and Switzerland do not need a residence permit to work in Germany, and there is no fee for ordinary residence. However, documentation of residence is not entirely free of charge.
From a professional perspective, this does not change anything: the recognition of the qualification and the permission to use the professional title are required in all cases.
For further information, Accelerated skilled worker procedure under § 81a AufenthG
The following list is an Model calculation for illustration, It does not offer or predict a specific case; it includes selected positions, not the entire process, and deliberately mixes two levels because employers pay for both.
Assumptions: a nursing professional with a third-country qualification, employment in North Rhine-Westphalia, equivalence examination with a deficit decision, compensation through the knowledge examination, accelerated professional qualification procedure used, additional language examination required, no GfG expert opinion necessary.
| Position | Level | Amount |
|---|---|---|
| Equivalence assessment, District Government Münster | Recognition | 150,00 € |
| Organization of the knowledge test, two parts | Recognition | 40,00 € |
| Decision following successful settlement measure | Recognition | 37.50 to 87.50 € |
| Permission to hold the professional title with a language test | Recognition | 80,00 € |
| Accelerated skilled worker procedure | Stay | 411,00 € |
| National visa | Stay | 75,00 € |
| Residence permit, issuance | Stay | 100,00 € |
| Total amount of these positions | 893.50 to 943.50 € |
Not included and to be added depending on the case: an expert opinion from the GfG, the examination costs of the nursing school, expenses for the authorities, translations and certifications, and everything else that is mentioned in the next section.
None of the following positions are included in a fee schedule, and together they exceed the fees by a multiple.
In cases involving graduates from third countries, Section 40(3a) of the PflBG opens up a second option: the professional can forgo the individual equivalence assessment and proceed directly to the knowledge assessment or adaptation course. The documented benefits include fewer documents, less translation effort, and a shorter processing time.
A cheaper overall route is therefore not guaranteed. The omission leads directly to an offsetting measure, which in turn incurs costs, and it is finally. He cannot withdraw it. Therefore, this decision should be at the beginning of the proceedings and not in the middle of it.
There is no uniform legal cost allocation. Which side bears which position is determined by the respective relevant legal requirements and effective contractual agreements. There is therefore room for negotiation, but not unlimited: individual positions are legally excluded from being shifted to the professional.
The „Fair Recruitment for Care in Germany“ seal serves as a guideline beyond the negotiation process. It works in conjunction with the Employer Pays PrincipleThe costs of recruitment and the procedure are borne by the employer, not the skilled worker recruited. This standard is binding only for certified placements, and it is not a legal requirement. It remains a useful reference point for one's own agreement.
This distinction is crucial for contract drafting, and it is often overlooked.
The brokerage commission. A pre-formulated clause requiring the professional to reimburse a brokerage commission paid by the employer to a third party if they terminate the employment relationship themselves before the expiration of a deadline is invalid. The Federal Labour Court decided so in a judgment of June 20, 2023 (1 AZR 265/22), and assessed the clause as an unfair disadvantage under § 307, paragraph 1, sentence 1 of the German Civil Code (BGB). The reasoning: The clause impairs the freedom of choice of workplace protected by Article 12, paragraph 1 of the Basic Law on the Constitution of the Federal Republic of Germany (Grundgesetz der Bundesrepublik Deutschland), since the employer bears the entrepreneurial risk of its personnel recruitment itself, and the professional does not receive any benefit that would compensate for this impairment.
Training and qualification costs. Here things are different, and the court also states why in the same decision: Unlike in the case of a brokerage commission, the professional gains an advantage through qualification that is independent of the duration of the employment relationship and can also be used with another employer. Therefore, reimbursement clauses for qualification costs are not inherently invalid. However, they are subject to their own requirements regarding the duration of the binding period, proportionality, and differentiation based on the reason for termination, and must be examined from a labor law perspective before being included in the contract.
For the written agreement, this means: Separate the positions according to Art. Which costs your facility covers is included. A refund of the brokerage commission in the event of early termination does not belong here.
There is much talk about funding programs, but they are rarely properly identified. What matters is not whether there is funding, but who is allowed to apply for them and what position it actually covers.
This benefit under §§ 81 and 82 of the Social Security Act III consists of two separate benefits that are allocated differently. The benefit for course costs is linked to the employed person and their participation in the measure. The allowance for wage compensation is granted to the employer. For several comparable qualified employees, the employer may submit a collective application under the statutory requirements.
These percentages are maximum limits within the legal requirements and are not a commitment. Whether and how much funding is provided is decided on a case-by-case basis by the Federal Employment Agency. The size of the business is measured according to the entire company and, if applicable, the group of companies, not according to the individual unit. Furthermore, a measure of more than 120 hours of instruction is required, as well as a measure approved by AZAV at an approved provider.
The timing decides. The advice provided by the Employment Agency and the education voucher must before The start of the measure is known. If the professional is only sent to the adaptation training program after submitting the application, they will no longer be eligible for funding for this measure. The contact person is the employer service.
For care professionals undergoing the recognition process, § 45a AufenthG provides for a special course for health professions with a target level of B2. Eligible participants include employees and individuals with signed employment contracts, as well as individuals who attend the course in conjunction with the recognition process.
The federal government funds the courses. A cost contribution equal to half of the reimbursement rate applies only to a portion of the participants, and the employer can cover it. Liberated are, according to the German Language Promotion Ordinance, in particular:
Those who pay the contribution will receive half of it back within two years upon successful certification of their qualifications upon request. The contribution and exemption rules were changed in 2026, which is why the current amount and income threshold can be requested from the Federal Office for Migration and Refugees or the course provider.
Only natural persons are eligible to apply., Not the employer. The professional must have their habitual residence in Germany and fall within the income limits, currently 32,000 euros for single people and 50,000 euros for cohabiting spouses or life partners.
Up to 600 euros are funded for the recognition process and up to 3,000 euros for qualification, including adaptation courses and preparation for aptitude or knowledge tests. Examination fees are generally eligible for funding.
Three exclusions are important for budget planning because they relate to the positions listed in the tables above.
The application must be submitted before the start of the cost-causing measure. The directive runs until the end of 2028; applications are possible until June 30, 2027.
Funded by the federal government and the EU, in the 2026-2028 funding round. IQ advises on recognition and qualification, conducts qualifications, and explicitly targets companies and their employees as well. Money does not flow to the employer here, but there is certainly funding for advice and qualification places.
In addition, the federal states are developing their own programs. These often change, which is why the exam should be project-specific and not based on a list.
The fees charged by the states for third-country qualifications in the seven federal states compared here range from around 80 to about 350 euros for the equivalence examination and permit itself, with North Rhine-Westphalia also charging more depending on the administrative workload involved. In addition, depending on the case, there is a fee from the medical profession review body, costs for the compensatory measure, translations, and, for third-country nationals, the residence-related regulatory fees.
Because the states are responsible for recognition in the care professions and each country has its own fee regulations. They differ not only in amount but also in the average: Berlin charges a fee for the entire procedure, other countries charge the equivalence decision and the certificate separately, and in North Rhine-Westphalia two authorities are involved with their own fees. The recognition granted once then applies nationwide.
In none of the audited country regulations is it included as a fee charge, because the examination is usually taken and invoiced by a nursing school. The Hamburg Social Services Authority’s brochure usually lists approximately 300 euros for the oral part and approximately 500 euros for the practical part; these amounts are based on a separate figure from December 2023. The 20 euros per examination section in North Rhine-Westphalia represent the fee for the organization by the authority, not the price of the examination itself.
The continuing education funding under §§ 81 and 82 of the Social Security Act III is intended to support participation in a qualification, and the allowance for the employee’s wage is paid to the employer. For several comparable qualified employees, a collective application is possible. The percentages are maximum limits within the statutory requirements; there is no commitment, and advice and education vouchers must be available before the start of the measure. The Federal recognition grant can only be applied for by the professional themselves, and the fee for the license to use the professional title is excluded from this.
No. The recognition allowance excludes fees that are incurred for professional certification and thus the permission to use the professional title. Language courses and their examination fees are also excluded. Examination fees are, by the way, eligible for funding.
It reduces the workload for documents, notarizations, and translations and speeds up processing. The overall process is not automatically made more favorable as it directly leads to an offsetting measure. What is crucial is that the waiver under § 40, paragraph 3a PflBG is final.
Yes. The 411 euros are collected under § 47, paragraph 1, no. 15 of the AufenthV for the conduct of the proceedings, regardless of the outcome. The procedure is voluntary.
No, not through a pre-formulated contractual clause. The Federal Labour Court ruled with a judgment of June 20, 2023 (1 AZR 265/22) that such a clause is invalid under § 307, paragraph 1, sentence 1 of the German Civil Code (BGB). The employer bears the entrepreneurial risk of its personnel recruitment itself, and the professional receives no countervailing benefit through the commission. This does not apply to qualification costs in the same way, because the professional gains a transferrable advantage there. Such reimbursement clauses are subject to their own requirements and are subject to labor law review.
They do not need a residence permit for employment, and there is no fee for ordinary residence. However, documentation is not free of charge on a continuous basis. Swiss nationals who obtain their right of residence as a chip card pay the fee for a German personal identity card in accordance with § 52, paragraph 2 of the AufenthV, currently 46 euros and 27.60 euros before the age of 24. A certificate of permanent residence for Union citizens costs 10 euros. Professional recognition is required in all cases.
For the employer, adopted procedural, qualification and language costs are generally operating expenses. How to treat the individual case, in particular the question of whether there is a tax-deductible benefit for the professional, is a matter for tax advice.
Tell us which state you are hiring in, from which country the professional comes and what level of language knowledge they have. This will determine which fees apply, which recognition pathway is appropriate, and which funding is available. The consultation is free of charge and there is no obligation to proceed.
Further information: Hiring care workers from abroad: the complete guide · Recognition of foreign qualifications · nursing knowledge examination · Deficit notice · Personnel recruitment nursing
Fees of the Länder
Examinations and legal basis
Promotion and standards
Status: October 2026. The overview covers seven federal states and is not a complete comparison of all sixteen. Fees, funding conditions, and responsibilities are subject to change. Several of the linked country pages do not have an updated date, and individual amounts are indicated by the authorities themselves as guidelines. In each individual case, the information provided by the competent authority is decisive. This article provides an overview and does not replace legal, labor law, or tax advice in individual cases.