Private practice, by the numbers
For therapists, psychologists and counsellors: how many sessions you really hold once no-shows and time off are in, what you earn per hour once notes are counted, the caseload a target income needs — and a sliding fee scale you can defend.
Fees, insurance and costs
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A fee that follows income
Full fee above one household income, a floor below another, and a straight line between — rounded to $5 so it's easy to quote.
Planning figures, before tax. Self-employment tax, retirement and health insurance come out of the take-home shown here. Check insurer contracts and your licensing board's rules on no-show fees and sliding scales.
How it's worked out
Sessions held = weeks worked × sessions booked a week × (1 − no-show rate). Session income uses a blended fee: your private fee for the private share and the insurer's rate for the insured share. Late-cancel fees only apply to private clients (insurers generally don't pay for missed sessions, and billing insured clients for them depends on your contracts), times the share you actually collect.
Per hour divides take-home by the hours held sessions really take, including the notes, scheduling and billing time you set per session. Sessions needed a week is the fewest bookings that reach your target after overhead.
Why the fee isn't the hourly rate
A $150 session isn't $150 an hour. Each clinical hour carries notes and admin; some bookings don't happen; holidays, training and sick weeks come out of the year; and rent, supervision, insurance and software come out of what's left. Most clinicians who work it through find their real hourly figure is well under half the fee — which is why a caseload that sounds light can be the right one.
No-shows are the lever people underrate
At twenty sessions a week, every point of no-show rate is about nine sessions a year. The Lost to missed sessions figure shows what they cost you after any late-cancel fees you collect. Reminders, a clear cancellation policy and a card on file usually move it more than a fee rise would.
Related
The reliable change calculator helps with outcome measures, and what therapy costs helps clients understand in-network, out-of-network and superbill options. The guide to measuring progress in therapy covers measurement-based care.
Questions people actually ask
How many clients does a full-time therapist see?
Many private-practice clinicians hold somewhere around 20 to 30 sessions a week; fewer is common when notes, supervision and admin are counted honestly. Use the planner to find the number that meets your income with the hours you want.
How do I set a sliding scale?
Pick your full fee, a floor you can sustain, and the household incomes at which each applies; the table fills in between. Decide how many sliding-scale places you can offer and write the policy down.
Does this page store my figures?
No. Everything is worked out in your browser and nothing is saved or sent.