In addition to providing tips and guidance on how to set your rates, we also included the median therapy session rates for all 50 states and metropolitan areas in 2017. Based on over six million sessions billed through SimplePractice, this information provides an extremely reliable way to see how your rates compare to others in your state or region
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How to set your rates in a private therapy practice.
1. “Therapists are notoriously... phobic around talking
about money. We can talk about sex, we can talk about
molestation, we can talk about infidelity, we can talk
about suicidality, we can talk about death, we can talk
about afterlife and anything else, but somehow we often
will not address the issue of money.”
OFER ZUR, ZUR INSTITUTE1
Make what
you’re worth:
How to set your rates in
private practice
February 2018
LEARNING
2. Foreword
Your session rate says a lot about your expertise and value. If you
charge significantly more than your peers, potential clients may
look elsewhere, and if you charge significantly less than your peers,
clients may perceive your low rate as an indication of low value.
Without conducting a full-scale market analysis, however, it’s
difficult to know if your rates are comparable with other similarly-
situated therapists in your area. Obviously, deciding what to charge
clients is a combination of several factors, but knowing how much
other therapists in your area charge per-session can be the first
step to ensuring you are not short-changing yourself.
Therefore, in an effort to help you feel confident about setting
orraisingrates,weputtogetheraguide,whichincludesthefollowing
sections:
1. Diving into the ‘black box’ of therapy rates
2. Raising your rate: 5 tips to help therapists navigate the
transition with ease
3. 3 tips for charging the rate you deserve
Our intent is to empower you with information and data so you can
make informed decisions when setting or raising your rates.
1
Zur, O. (2016). Fees in therapy: Summary and guidelines. Retrieved Jan. 24, 2018
from http://www.zurinstitute.com/feeguidelines.html.
3. CHAPTER 1
Diving into the ‘Black
Box’ of Therapy Rates
Whether you’re new to private practice
or a seasoned practice owner, chances
are likely that you’ve struggled with this
question: What should I charge for a
therapy session? In other words, what’s
your rate? This is the amount you feel
your services are worth—not necessarily
the amount that insurers allow. Perhaps
you’ve asked a few local colleagues for
input, and you suspect your rate falls
within an acceptable range, but how
can you know for sure?
When setting your rate, it’s important
to strike a balance that supports
your financial goals and helps you
remain profitable over time.
“Setting your rate is probably one of the most
important aspects of starting your practice,” says
Daren Reifsneider, senior analyst at SimplePractice.
If your rate is too high, your clients may not be
able to afford your services. On the other hand, if
your rate is too low, your clients may perceive your
services as less valuable. With a low rate, you also
run the risk of burnout as you tirelessly increase
your caseload while barely covering your expenses.
When setting your rate, it’s important to strike a
balance that supports your financial goals and
helps you remain profitable over time.
Without access to detailed data
about rates, therapists keep their
fees relatively low out of fear that
they could lose clients or even go out
of business.
One reason why therapists struggle with setting
their rates is that it’s hard to find supporting data.
Therapists may suspect that their rates are too low,
but they don’t always have any evidence to support
this theory. Self-report survey data isn’t always
accurate, and the sample sizes may be too small. In
addition, the methodology may not be transparent,
making it difficult to draw actionable conclusions.
The result? Without access to detailed data about
rates, therapists keep their fees relatively low out
of fear that they could lose clients or even go out
of business.
The good news is that SimplePractice now provides
new insights that can help therapists gauge whether
they’re charging enough. Using data billed through
SimplePractice, customers now have access to
detailed information about what therapists charged
nationwide for individual therapy sessions in 2017.
The analysis, which provides city- and state-
specific median session rates, is based on more
than 6.7 million sessions rendered by therapists,
social workers, counselors, and psychologists in
private practices, Reifsneider explains.
In some ways, the data reflects what many therapists
already know—that is, there’s a wide range of rates
reported nationwide. For example, in Florida, the
median rate was $70, while in Alaska, it was $160.
1
4. NOTE: All data used in this analysis are completely anonymous, and SimplePractice does not sell data at any time for any reason. See Appendix for
additional information. SOURCE: SimplePractice. (2018) Setting your fees in private practice. Santa Monica, CA.
City & State Session Rates
Ever wondered what most therapists are charging for their services? We’ve
collected data from SimplePractice customers around the country to give
you a better idea of session rates by city and state.
1. Miami-Fort Lauderdale-West Palm Beach,
FL : $250
2. New York-Newark-Jersey City, NY-NJ-PA :
$175
3. Chicago-Naperville-Elgin, IL-IN-WI :
$150
4. Washington-Arlington-Alexandria, DC-VA-
MD : $150
5. Philadelphia-Camden-Wilmington, PA-NJ-
DE : $150
6. San Francisco-Oakland-Hayward, CA : $140
7. Atlanta-Sandy Springs-Roswell, GA :
$125
8. Seattle-Tacoma-Bellevue, WA : $125
9. Los Angeles-Long Beach-
Anaheim, CA : $120
10. Houston-The Woodlands-
Sugar Land, TX : $120
11. Denver-Aurora-Lakewood, CO
: $120
12. Boston-Cambridge-Newton,
MA-NH : $100
13. Phoenix-Mesa-Scottsdale, AZ
: $100
14. San Diego-Carlsbad, CA : $100
15. Tampa-St. Petersburg-
Clearwater, FL : $100
16. St. Louis, MO : $90
17. Dallas-Fort Worth-Arlington,
TX : $87
18. Riverside-San Bernardino-
Ontario, CA : $80
19. Detroit-Warren-Dearborn, MI
: $75
20. Minneapolis-St. Paul-
Bloomington, MN-WI : $75
LOWEST
RATE
HIGHEST
RATE
MEDIAN SESSION RATES BY CITY
2
5. MAIN FINDINGS:
• Nationwide, the median rate for 2017
was $120.
• Five states (Florida, Indiana, Michigan,
Missouri, and Ohio) had median rates
at or below $90.
• Seven states (Alaska, Iowa, Illinois, New
Jersey, Arkansas, District of Columbia,
and Hawaii) had median rates at or
above $150.
• 10 states (Connecticut, New
Hampshire, Pennsylvania, Rhode
Island, Vermont, Alabama. Maryland,
California, Oregon, and Wyoming) had
rates at $120.
AMONG THE METROPOLITAN
AREAS WE INCLUDED IN
THIS REPORT, THE HIGHEST
RATES WERE:
• Miami-Fort Lauderdale-West Palm
Beach, FL at $250
• New York-Newark-Jersey City, NY-NJ-
PA at $175
• San Jose-Sunnyvale-Santa Clara, CA
at $165
LOWEST RATES:
• Louisville, KY, $80
• Cincinnati, OH, $82
• Jacksonville, FL, $82
• Dallas-Fort Worth-Arlington, TX, $87
There’s also variation within a single state—urban
areas often reflected a higher median compared to
that of the state overall. For example, New York
state had a median rate of $125, while the median
rate in the New York City area was 40% higher at
$175. Another example, Florida, had the lowest rate
among the states. Yet, the Miami-Palm Beach area,
with a rate of $225, was the highest of all 50 cities
included in this study.
Some of these variations may correlate with
differences in the cost-of-living, while others may
be linked to supply and demand. For example,
rates may be higher in areas where there are fewer
therapists.
The biggest takeaway for therapists is that “this
data can serve as a starting point when establishing
one’s fees,” says Reifsneider. Therapists should
ideally be at, or above, the median in their locale.
Factorssuchaslevelofeducation,licenseordegree,
specialized training, and years of experience should
also be taken into consideration, she adds.
“This is the first time we’ve used our internal data
to provide a tool for our community,” says chief
operating officer, Fletcher Dennison. “Our hope is
that we can help people charge with confidence.”
The 2017 session rate data will be the first of many
updates, says Dennison. SimplePractice hopes
to segment the data even further by correlating
median rates, for example, with credentials or
years of experience—all with the goal of helping
therapists set fair rates nationwide.
3
6. CHAPTER 2
Raising Your Rate: 5
Tips to Help Therapists
Navigate the Transition
with Ease
You’re in back-to-back sessions all day
every day, but your profit-margin never
seems to reflect the endless hours
you work. Although it’s tempting to
normalize this and shrug it off as the
cost of doing business as a therapist,
this grueling routine doesn’t need to
be your reality. In fact, you can literally
transform your business and achieve
the life you want by taking one simple
step: Raise your rate.
There are two important reasons why therapists
should raise their rates. First, a higher rate can
help support a viable business. You may enter
the profession using a rate that’s far too low in
the hopes that it will attract clients. Even when
business is booming, the downside is that you
quickly experience significant burnout.
“You try to cram so many clients into your schedule
because your fees are not high enough,” says
Jessica Improta, LCSW, a clinical social worker in
private practice and a consultant at SimplePractice.
Second, a higher rate offsets expenses that
naturally increase as the cost of living goes up.
Most companies provide annual cost of living salary
increases for this purpose, and your practice
should not be an exception.
What prevents therapists from raising their rates?
Fear. More specifically, therapists tell themselves
the following:
• My existing clients will leave.
• I won’t gain any new clients.
• My colleagues will perceive me as greedy.
• I don’t deserve the higher rate because my
work isn’t good enough.
“It’s these conversations that therapists have
internally that really prohibit them from setting a
fee that’s fair—and then raising that fee on a regular
basis,” says Improta.
Stating that your rate may
increase once a year gives you the
flexibility to keep your rate the same
or raise it annually as business
expenses increase.
Not sure where to begin when raising your rate?
Consider these five tips to help you get started:
1. Include language in your informed consent about
a potential rate increase. Stating that your rate may
increase once a year gives you the flexibility to keep
your rate the same or raise it annually as business
expenses increase.
2. Decide when—and by how much—you’ll raise
your rate. For example, will you raise it every year
on January 1st? Another option is to raise it on an
annualized basis per client. This means if you start
seeing a client in November, you wouldn’t raise
their rate until the following November.
4
7. At a minimum, consider increasing your rate to
reflect the cost-of-living adjustment (COLA).
In 2018, the COLA is 2%, according to the Social
Security Administration. For a therapist who
charges $100, this would mean a $2 increase per
session. This is a nominal amount for each client;
however, when multiplied by 20 clients per week, it
equates to an additional $160 per month or an extra
$1,920 annually.
Consider language such as “As you
know, I haven’t raised my fee in the
last year. I want to let you know that
I’m increasing my rate in January. My
new fee will be $120.”
Also consider whether you’ll raise your rate for
all clients or only for new clients. If you raise it
only for new clients, and most of your clients are
established, you could lose out on revenue. On the
other hand, keeping your rate the same for current
clients gives you a solid base of business as you
assess how the market handles your rate increase.
3. Tell your clients verbally about the increase. For
example, consider a two-month verbal notice and
a three-week written notice to clients. When telling
clients about your rate increase, keep it simple and
straightforward.
“As therapists, we model communication that’s
open and direct,” says Improta.
Consider language such as ‘As you know, I haven’t
raised my fee in the last year. I want to let you know
that I’m increasing my rate in January. My new fee
will be $120.’
4. Be prepared for client reactions. Most clients
will understand that a rate increase is a necessary
part of running a business. However, if a client
perceives the rate increase as a personal attack,
it might be a good opportunity to explore what is
coming up for the client.
If clients can’t—or won’t—pay your increased rate,
you need to have a backup plan. For example, can
you offer a sliding scale or a package (discounted)
rate for multiple sessions? Some therapists have a
referral list ready, including referrals to interns as
well as other therapists who are willing to provide
services at a lower rate.
5. Remember that raising your rate is about
building your practice and a life that works for you.
You may lose one or two clients once you raise your
rate, but the clients who remain will be more likely,
willing, and able to pay.
If clients can’t—or won’t—pay
your increased rate, you need to
have a backup plan. For example,
can you offer a sliding scale or
a package (discounted) rate for
multiple sessions?
5
8. CHAPTER 3
3 Tips for Charging the
Rate You Deserve
You’ve earned your degree, honed your
skills, and ventured out into the world
of private practice. Now comes the first
hurdle. How much do you charge for a
session? This question causes anxiety
even for experienced therapists. You
want to be paid fairly, but you may have
a difficult time assigning a monetary
value to the services you provide.
“What ends up happening is that many therapists
ultimately err on the side of caution when setting
their rate,” says Dennison “They have a big lack
of confidence in terms of charging what they’re
worth,” he says. “They fail to recognize that they’ve
spent a tremendous amount of money and time
investing in their education and their preparation
to be able to do this very difficult work.”
Many therapists... fail to recognize
that they’ve spent a tremendous
amount of money and time investing
in their education and their
preparation to be able to do this very
difficult work.
“When therapists underestimate the value of
their services, they essentially undermine their
own business,” says Dennison. “I’ve spoken with a
number of providers who have gone out of business
because they were not able to support themselves.
They couldn’t make the business side of the
practice work,” he adds.
Improta says she isn’t surprised that therapists end
up closing their doors due to financial hardships.
The misleading messaging that therapists receive,
even during their academic training, is that the
mental health profession simply isn’t lucrative.
You can make a good living, take care
of yourself, and take great care of
your patients by setting the right fee.
“Theideathat‘therapistsdon’tgointotheprofession
for the money,’ is somewhat disingenuous because
every therapist needs to think about money to
sustain their business,” she says. “You can make
a good living, take care of yourself, and take great
care of your patients by setting the right fee,” she
adds.
Charging a fair rate allows you to accomplish the
following:
• Avoid burnout
• Cover business and personal expenses
• Maintain a healthy work-life balance
• Offer one or more sliding scale appointments
to clients in need
• Provide pro bono work if you choose to do so
Consider these three tips when setting your rate:
1. Remember that you’re an entrepreneur. “Even
though you’re in the business of helping others,
you’re also technically the chief executive officer
of your own company. This means you shouldn’t
view your practice differently than any other small
business owner,” says Dennison.
6
9. This question is paramount: How much revenue
must you earn to cover your expenses? This includes
business expenses (e.g., rent, taxes, liability
insurance, professional association memberships,
continuing education, and practice management
software) as well as personal expenses (e.g.,
student loans or a mortgage). Calculate a total, and
then add a buffer for peace of mind. You need to
earn more than this amount to maintain a profitable
business.
Next, determine how many clients you want to see
weekly and whether you plan to take time off for
vacation throughout the year. For example, you set
a goal of seeing 20 clients per week and plan to take
four weeks of vacation time annually. Determine
your hourly rate using this calculation:
Business Expenses + Personal Expenses
20 clients per week
=
(Dollar amount)
÷
48 weeks per year
=
YOUR HOURLY RATE
Improta says doing the math ultimately helps her
set a rate that allows her practice to thrive without
leaving her vulnerable to burnout.
2. Determine whether your calculated rate is
reasonable for your area. Therapists in urban
areas, for example, may be able to charge more
than their rural counterparts. Asking a few local
colleagues about their rates is helpful, but it also
doesn’t necessarily provide a well-rounded view.
Instead, try to seek a larger sample size.
Asking a few local colleagues about
their rates is helpful, but it also
doesn’t necessarily provide a well-
rounded view.
For example, you can glean this information using
a tool like Psychology Today that includes average
costs per session for therapists in specific zip
codes. Take a sample size of 10 or more therapists
in your area. Examine this data by calculating the
average, median, maximum, and minimum rates.
This gives you a good idea of how the rates are
distributed. Better yet, SimplePractice provides
more in-depth rate data, including state- and city-
specific medians based on 6.7 million sessions,
billed by therapists nationwide.
If your calculated rate falls above the range for
your local area, are there any factors that can help
you justify the higher rate? Do you have significant
experience or specialized training? For example,
you may be able to charge more if you’re the only
therapist in your area who provides Eye Movement
Desensitization and Reprocessing (EMDR).
Are there any factors that can help
you justify the higher rate? Do you
have significant experience or
specialized training?
“If you can’t justify the higher rate, you may need
to consider other alternatives, such as adding
an additional client to your weekly caseload or
supplementing your income by running a therapy
group,” says Improta. Over time—and as you gain
experience—consider increasing your rate.
7
10. 3. Consider a limited sliding scale. Setting your rate
might mean including the option for a sliding scale.
Doing so allows you to take on additional clients who
might not be able to afford your full rate. Decide
in advance how many sliding scale clients you can
afford to take on, and stay firm with your offerings.
For example, if you decide to offer a sliding scale to
two of your 20 clients, don’t continue to offer this
reduced rate once those slots are full.
Ultimately, setting the right rate helps you maintain
a profitable practice that allows you to focus on
what you do best: helping your patients.
Appendix
A NOTE ON CUSTOMER PRIVACY
We do not sell customer data to third parties, nor do we publish data that could be linked to a practice or clinician. Furthermore,
when we do publish research on customer data, it is always aggregated and never contains personally-identifiable information.
METHODOLOGY
The data included in this report reflect actual session rate data billed by SimplePractice customers in 2017. Therefore, rather than
relying on self-report survey data (i.e., a clinician would be asked how much he or she typically charges for a 50-minute session of
therapy) which, the rates included in this report are generally considered more reliable.
This report includes 6.7 million session fees collected in 2017, from nearly 19,000 unique SimplePractice customers located in all 50
states and the District of Columbia. To assure comparable data, we used the following inclusion criteria:
• Billed from January 1 through December 31, 2017.
• Billed using CPT code 90837. This code is for psychotherapy.
• Billed for 50 or 60-minute sessions.
• Practices located in the U.S.
Next, we calculated the median rates for each state and the top 50 metropolitan statistical areas (MSA) areas, as defined by the
United States Office of Management and Budget (OMB). We chose the median value rather than the mean to report this data. The
problem with using the mean is that it is affected by extreme values that are very high or very low compared to the rest of the sample.
We believe the median is better than the mean for summarizing values in this study because it represents the amount that a session
is most likely to cost, and It is less likely to be influenced by extreme values.
To protect clinician & practice privacy, we only included rates in cities and states with a sufficient number of unique practices. North
Dakota was the only state with under 5,000 total sessions, however since this total included sessions with an adequate number of
unique practices and their rate seemed reasonable, we felt comfortable including them with a disclaimer to interpret with caution.
Limitations
The primary limitation is that the rates reported do not distinguish whether or not insurance was used to pay some or all of the
amount billed. From speaking to dozens of clinicians, they often report their fees are generally more than the actual payments they
receive from insurance companies and clients. Additionally, despite the sheer volume of data collected from almost 19,000 unique
practices, it may not accurately represent the private practice therapy market. Therefore, this study should be considered more of
an examination and analysis of the session rates of SimplePractice customers and used only for comparison purposes.
If you would like additional information on this study, please contact Daren Reifsneider at daren@simplepractice.com.
8
11. STATE NAME
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota *
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Total
MEDIAN
SESSION RATE
$160
$120
$150
$110
$120
$115
$120
$150
$111
$70
$100
$150
$150
$100
$150
$80
$100
$100
$98
$113
$120
$125
$90
$125
$90
$112
$135
$125
$125
$140
$120
$150
$128
$110
$125
$90
$111
$120
$120
$120
$100
$140
$130
$100
$110
$100
$120
$130
$130
$100
$120
$120
NO. OF
SESSIONS
22,071
51,244
22,458
109,725
1,302,197
233,409
125,176
37,540
8,797
185,803
137,435
20,654
20,391
30,688
297,728
59,211
40,494
47,956
43,330
210,015
169,859
29,725
80,567
52,663
62,836
22,630
62,873
203,516
3,215
38,661
27,647
156,425
25,249
27,873
489,463
105,014
35,391
224,009
199,106
42,060
68,111
13,404
105,009
583,609
170,995
166,379
22,318
432,853
58,587
11,940
9,180
6,707,489
TABLE 1
Median session
rates by U.S.
state, 2017
NOTE: Asterisks (*) indicate
the state had a small sample
size, and therefore should be
interpreted with caution.
SOURCE: SimplePractice. (2018)
Setting your fees in private
practice. Santa Monica, CA.
Available online at
www.simplepractice.com/blog
12. CITY
New York-Newark-Jersey City, NY-NJ-PA
Los Angeles-Long Beach-Anaheim, CA
Chicago-Naperville-Elgin, IL-IN-WI
Dallas-Fort Worth-Arlington, TX
Houston-The Woodlands-Sugar Land, TX
Washington-Arlington-Alexandria, DC-VA-MD
Philadelphia-Camden-Wilmington, PA-NJ-DE
Miami-Fort Lauderdale-West Palm Beach, FL
Atlanta-Sandy Springs-Roswell, GA
Boston-Cambridge-Newton, MA-NH
San Francisco-Oakland-Hayward, CA
Phoenix-Mesa-Scottsdale, AZ
Riverside-San Bernardino-Ontario, CA
Detroit-Warren-Dearborn, MI
Seattle-Tacoma-Bellevue, WA
Minneapolis-St. Paul-Bloomington, MN-WI
San Diego-Carlsbad, CA
Tampa-St. Petersburg-Clearwater, FL
Denver-Aurora-Lakewood, CO
St. Louis, MO
Baltimore-Columbia-Towson, MD
Charlotte-Concord-Gastonia, NC-SC
Portland-Vancouver-Hillsboro, OR-WA
Pittsburgh, PA
Orlando-Kissimmee-Sanford, FL
San Antonio-New Braunfels, TX
Sacramento-Roseville-Arden-Arcade, CA
Kansas City, MO
Cincinnati, OH
Las Vegas-Henderson-Paradise, NV
Cleveland-Elyria, OH
Austin-Round Rock, TX
Indianapolis, IN
Nashville-Davidson-Murfreesboro-Franklin, TN
Columbus, OH
San Jose-Sunnyvale-Santa Clara, CA
Virginia Beach-Norfolk-Newport News, VA-NC
Providence-Warwick, RI-MA
Milwaukee-Waukesha-West Allis, WI
Oklahoma City, OK
Jacksonville, FL
Raleigh-Durham-Chapel Hill, NC
New Orleans-Metairie, LA
Louisville/Jefferson County, KY-IN
Richmond, VA
Memphis, TN
Hartford-West Hartford-East Hartford, CT
Salt Lake City, UT
Buffalo-Cheektowaga-Niagara Falls, NY
Birmingham-Hoover, AL
MEDIAN
$175
$120
$150
$87
$120
$150
$150
$250
$125
$100
$140
$100
$80
$75
$125
$75
$100
$100
$120
$90
$150
$125
$120
$100
$68
$100
$130
$90
$82
$110
$130
$110
$80
$150
$95
$165
$120
$120
$95
$100
$82
$150
$90
$80
$95
$97
$120
$115
$125
$120
TABLE 2
Session rates
by top U.S.
cities, 2017
SOURCE: SimplePractice. (2018)
Setting your fees in private
practice. Santa Monica, CA.