Fees_ Are You Focusing on the Right Thing?


For therapists who are starting a practice, especially a cash therapy practice, determining what fees to charge is often an excruciating experience.

Most of us would instead do a hundred ab crunches rather than tell a new client our full fee.

Fees: Does This Feel Familiar.

You’ve diligently done your homework. You’ve run the numbers. You’ve talked to a friend in the business. Your website explains your fees in detail.

You know how hard you work. You know what you know. You’re jacked up to charge what you’re worth.

You’ve convinced yourself that your fee is fair. You know what you need to pay the bills.

Now a prospective client is sitting in front of you. You patiently listened to her talk about her problems. You asked great clarifying questions. You explain in simple terms what you do and how you can help make her life better.

Everything is going great. The client is eager, friendly, and definitely could use your help. You’re thinking to yourself; she might be THE ONE.

And then she says it. “What’s your fee?”


You know what to say. You’ve rehearsed it many times in your head. You’ve talked about it ad nauseam with your spouse and friends. Now’s the time to say it out loud.

You hear yourself saying,

Me? My full fee? Um, I charge…um…one twenty-five per session. (Silence) But what can you…I mean…times are tough. What can you afford? Is $75, okay? How about $50? I’ve been thinking about a sliding scale or taking payments, would that work for you?

Ugh. Once again, you’ve found yourself agreeing to provide premium care at a ridiculously low price that you regret the minute she walks out of the room.

New practice owners or therapists who struggle to make ends meet often distracted by the wrong things. The number one concern of therapists I mentor is:

How can I get more clients?

While attracting more clients by getting the word out is essential. Determining the right fee is equally necessary. Many therapists put far too much emphasis(and money) on building a great website, printing brochures, and Facebook ads rather than pricing.

Don’t get me wrong; marketing is essential. But ultimately, the success or failure of your therapy practice depends on charging the right amount for your services.

Determining your fees based upon what other therapists or what insurance pays is no guarantee of success. In reality, if the other therapists are struggling to make ends meet– most likely, you will too.

Insurance companies are in the business of making money for their stakeholders, not helping you earn a liveable income.

Fees: Where Do You Start?

The first step in knowing what to charge is:

Acknowledge and accept that it is the most critical factor in predicting the ultimate realization and enjoyment of your practice.

Until you do, you’ll be like most therapists who determine their fees based up guilt, anxiety, or just default to the “going rate.” Then they try to make up the difference in increasing the volume of patients they see. 

Commit right now to do the hard work to:

  1. Calculate a budget based upon your financial needs(including student debt, healthcare) and what you need to charge to cover your expenses and a monthly livable wage.
  2. Charge that fee.

No really, I mean it. Say to yourself out loud right now! Promise yourself you’re going to do whatever it takes to understand what you need to confidently charge to make a good living. 

If you find yourself, not having calculated your actual cost per visit or assessed your local market, don’t despair. Stay tuned.

I’ll be sending you a series of articles to help you determine what to charge based upon your needs–not your clients. No one benefits from burned-out therapists struggling to do what they love and make ends meet. 

Next up: Fees: What’s A Therapist’s Time Worth?