OBJECTIVES: In our earlier cross-sectional analyses of physician involvement in health care provision for patients with a diagnosis of ADHD (for year 2003), we observed that only 36% of children and adolescents and 33.5% of adults had been seen by a CNS specialist.  The present study revisits health care provision for ADHD patients by physician group. METHODS: Patient-level data were extracted for analysis from the physician-centered claims database of the Kassenaerztliche Vereinigung (KV) in Nordbaden / Germany, which covers the entire regional population enrolled in statutory health insurance (>2.2 million lives).  For calendar year 2009, 21,287 patients with ADHD [“hyperkinetic disorder”, HKD; ICD-10 codes F90.0 or F90.1] (male, 15,108; female, 6,179; including 5,931 patients or 27.9% [male, 4,582; female, 1,349] with coexisting conduct disorder [HKCD; F90.1 or a combination of F90 and F91]) were available for analysis of health care provider contacts. RESULTS: Overall, the rate of ADHD patients seen at least once by a CNS specialist (physician) increased from 42.0% in 2003 to 49.1% in 2009; the rate of those seen at least twice during the calendar year increased from 26.4% to 33.2% (for age group 0-5 years, from 9.1% to 11.1%; 6-12 years, from 27.4% to 33.7%, 13-17 years, from 30.3% to 33.1%, 18+ years, from 26.4% to 33.2%.  Patients with HKCD were more likely to be seen by CNS specialists than patients with HKD only.  Most children (in 2009, 84.4%) and adolescents (61.0%) were seen at least once by a pediatrician.  The rate of patients seen by psychotherapists remained stable at ~10%.  Within provider groups, health care for patients with ADHD was highly concentrated.  Each child and adolescent psychiatrist treated, on average, 231 patients with ADHD. CONCLUSIONS: Despite a moderate increase since 2003, CNS specialist involvement in health care provision for patients with ADHD remains relatively low.