In the last week, I’ve spoken (or emailed) with four new professionals who are each struggling to ask for their desired fees. If you know what the Usual and Customary Fee is for mental health professionals and are still struggling to ask for that fee, then you need to get better at justifying (to yourself and others) why your services are worth that amount. Here are a few thoughts to help you do just that.
- According to the US Census Bureau, only 2.1 % of the population in the United States of America has earned a Master’s degree and 1.5 % of the population in the USA has earned a Doctorate. You are among the most educated in this country.
- How many years experience do you have in mental health (pre- and post-graduate)? The more experience you have, the higher fees you can command.
- Do you have post-graduate certifications in certain areas?
- How many hours of post-graduate continuing education have you accrued? The more training and certifications that you acquire, the more justified you will be in asking for a higher fee.
- Do you have areas of continuing education in which you have accrued 45 or more hours of training? If so, you can state that you “specialize” in these areas – again allowing you to ask for higher fees.
- Do you have success stories that you can share to help others see exactly how you were able to help them?
- Have you considered what it can cost your potential client by not spending $100 / hour? Think about divorce, DUI’s, poor parenting, and even low self-esteem. Now talk about those costs.
Take some time to answer these questions and practice dropping this information into your telephone scripts with potential clients – long before you get around to discussing fees. And, if you still have difficulty asking for what you are worth, consider working with a professional like me to help you resolve those nagging little money issues.
What I know and you need to know is that you deserve to make an honest living helping people change their lives for the better.
What a great article, Tamara!
What I had never thought of was your last comment — the “cost” to the client if they do not spend the hourly fee — very true point and worthy of a thought-provoking discussion with the potential client.
Another bullet that was enlightening was the one about post-grad trainings. I thoroughly enjoy taking various trainings and now will more thoughtfully concentrate what classes I’m participating in so I might accrue 45+ hours to be considered an expert in that particular specialty.
Thank you for a very helpful article, Tamara…. I can see how this information will help guide my future professional rates!
Hi, Barbara! I’ve missed your voice here! Welcome back!
Thanks for your comments. You know . . . I don’t think our clients are always in the position to recognize those costs of not taking care of their business either. And, that point extends far beyond the clinical hour. I think about what it costs them when they don’t take care of their health needs or their social needs or their families’ needs, too.
So glad to be of help! Hope you’ll be back soon!
Tamara, I am confused about an aspect of setting fees. As one entering the private practice world, I am in the process of getting on insurance panels. Many really underpay in their allowable fees. I advertise that I charge a certain fee for an individual session, but that I also take what the insurance pays plus the client’s co-pay. If I specialize in something that I would like to make more money for, (such as DBT), how can I get that amount if I am locked into an insurance panel? Is the only way to go about this getting private pay clients? Any help from anyone on this question would be so appreciated! Thanks!
Linda, if you put “Managed Care” into the search box up found in the left sidebar of this blog, you will pull up lots of posts related to working with managed care. I would encourage you to examine why you choose to work with managed care. One of those reasons will not be to earn your full fee because that just doesn’t happen. Your colleagues who have chosen to work without the support of managed care can see 20 clients / week at the UCR; and, your colleagues who have chosen to work directly with managed care will most likely need to see 40 or more clients / week to make the same income. Of course, many of your colleagues choose to balance their practice with some percentage of each and their income would likely fall somewhere between the two.
What I would tell you is that it’s really important to be clear about your motivation to work directly with managed care . . . and FEAR is not a good reason to do so. The second thing I would tell you is that you should read and be familiar with the contracts that you have entered into with managed care.
If you believe that everyone deserves access to you and, because of that, you choose to work directly with managed care, then there are consequences to coincide with that choice. Those consequences may be positive . . . like a higher number of clients or they may be negative . . . like a lower rate of pay . . . or some combination of the positive and negative.
On the other hand, should you be working with traditional insurance companies, it is possible for you to expect your client to pay the difference between the insurance company’s reimbursement rate and your hourly fee. My point is that there are consequences for saying “yes” to working with managed care and you are 100% in charge of whether you choose to work with managed care at a reduced rate or whether you work directly with only with your clients and then allow them to settle up with their insurance companies.
The bad news is that it’s entirely up to you. The good news is it’s entirely up to you.
Tamara,
Thank you so much for taking the time to “talk” to me about this issue! I really, really appreciate it. I have read so many pros and cons about this that I can become confused, and I think you hit the nail on the head when you used the word “fear.” I live in a small town in Montana that does not have a very solid economic base. There are people who could afford my private pay fees, but not many. I have a question about one of the things you said, (On the other hand, should you be working with traditional insurance companies, it is possible for you to expect your client to pay the difference between the insurance company’s reimbursement rate and your hourly fee.)…I thought I had read in an issue of Counseling Today that if you signed up as a preferred provider, you cannot ask the client to reimburse you for anything beyond their co-pay. I may have misread that. I have often thought I should offer to fill out a superbill and let clients submit their own claims and then I would charge them my own fee, but unfortunately, I listened to other voices and jumped into things too quickly. Anyway, thank you so much Tamara. I will go on the blog an search the articles too. ;o)
One of the best things, Linda, about being in private practice is that you can change you mind and make better choices as you learn. I give my client a superbill and state in my disclosure statement that the client is solely responsible for my fee. If you decide that that is the direction you want to take your practice, then you can certainly transition to that . . . all at once or slowly.
I think the place that you are getting confused is with the term “preferred provider.” With different companies that can mean different things. And, with different therapists, they interpret “preferred provider” to mean different things. The easiest and simplest way to explain this is that you may charge whatever you deem to be fair and equitable PERIOD. However, if you have entered into legally binding agreements with managed care companies – typically by signing a contract with them – then it is likely that you have agreed (knowingly or otherwise) to certain conditions . . . one of which may be to accept a fee from them for your services that is less than your full fee. For this discussion, put the term “preferred provider” away and just focus on the contracts that you have agreed to and the ones that you may still be considering.
Again, barring any agreements that you have entered into that state otherwise, you can and should expect your client to pay your full fee and any difference between the reimbursement from the insurance company and your regular fee.
Linda, I’m glad you find this thread helpful and hope you’ll share it with your peers!
Thanks again Tamara…and I AM sharing this with my peers. Yesterday I met with a wonderful therapist and excitedly told her about finding you through the Counseling Today Magazine. I shared with her about all the help and support I have found through your site and links from your site. She is going to look you up! Thanks again Tamara…and I’ll go through my contracts with a fine tooth comb. I like your approach!
Thank YOU, Linda, for sharing the resources here to help us build a strong and vibrant community here at Private Practice from the Inside Out!
Thanks for this article! Something that I did when I was first starting to think about private practice and setting fees was to journal about what I provide to my clients. I wasn’t quite sure how that was going to go, but when I put pen to paper, I easily came up with two full pages of narrative about what I give to and do for my clients. This helped me think about being paid well for the work I do differently. When I did decide to work with managed care – which I did after doing some soul-searching about the population I want to work with and my desire to be accessible to them – I raised my full fee rate to help offset the amount of money I was losing by becoming paneled with an insurance company.
Jennie! Thank you so much for dropping in to chat and for taking time to share how useful it can be to journal about the value and worth that you provide to your clients! YES! I’ll be offering group to therapists later in the year on money-related issues and will definitely be incorporating this into the class . . . with a nod to you, of course!
I think this is the first time you’ve visited here . . . or at least the first time you’ve spoken up. Welcome! I hope you will drop in often to chat and share your experiences – the good and the bad with us here at Private Practice from the Inside Out. I think you will find that this is a vibrant and supportive community of therapists and allied health professionals focused on growing their businesses. We tend to be collegial, generous, and eager to network with each other – sharing our challenges and our resources. You are welcome to do the same!