Health and wellness professionals end up doing a lot of work for free. That often includes tasks that require professional expertise—tasks for which we could charge. Particularly for new practitioners, it can be difficult to identify where you’re providing free labor. But as a professional in your field, you deserve to be compensated for all the work you do for your clients—not just for your scheduled sessions.
If you do intend to charge for any services beyond your hourly rate, it’s important to be upfront about those charges. Consider putting a complete fee schedule into your initial consent documents with new clients, so there’s no confusion down the line.
In some states, it is a legal requirement to spell out all such charges in advance. Even where it isn’t required, doing so can avoid misunderstandings, and ensure that you’re not waiting for a check that never comes.
So What Should Be in Your Fee Schedule?
When you’re creating your fee schedule, think about the kind of work you’re likely to do with or for your clients outside of their sessions, and use that as a guide for what you should charge for. Here are a couple of common ones to get you started.
Some practitioners will try to put a steep court fee of several thousand dollars into their documents to discourage clients from ever involving them in court proceedings. But such fees may not keep you out of a courtroom forever. And if you do get called to court, you may not be able to collect that fee. Judges may require that you spell out the basis for your fee, and if you can’t justify it, they may limit what you’re able to actually collect. You should still have a fee in place for your time and your expertise, but make it an amount that you can defend.
Letters from healthcare professionals carry weight in a number of situations. Whether it’s a letter describing a client’s need for an emotional support animal, a letter to a workplace about the client’s symptoms that are keeping them away from work, these letters rely on your professional judgment and your professional licensure. They also take time to write and send. It’s reasonable to have a fee in place for such correspondence.
If you regularly speak with colleagues about their cases and provide guidance on care for their clients, you may want to consider charging for it. You can make distinctions here, like only charging licensed colleagues but not students or unlicensed professionals. If you’re sharing your expertise and time, it may be worth having a fee for those consultations in place.
Working with outside contacts
Phone calls back and forth with a client’s physician, social worker, or family members to collaborate on treatment planning often take meaningful amounts of time. Unless doing so is prohibited in your state, it’s reasonable to charge clients for these efforts. To avoid surprise bills for your client, make sure that they’ve seen your fee schedule ahead of time, so they understand what contacts you’ll be making, how often, and what the likely cost to them will be.
Typically, you can’t bill insurance for late cancellations or no-shows. But a client’s scheduled appointment is generally a time you reserve only for them, and if they cancel at the last minute, you may not be able to move another client into that slot. To discourage your clients from cancelling too late—and to make sure you still get paid if they do—it may make sense to have a late cancellation fee in place.
Of course, you can still choose to be reasonable with clients about things like illness—you don’t want to create a situation that encourages clients to come to the office when they’re sick.
Preferred time slots
This is also not typically allowed for insurance billing, but for cash-pay clients, evening and weekend sessions can often be billed at higher rates. Rather than framing this as a higher fee for preferred times, you could present the higher fee as your standard rate, with discounts for less-in-demand slots on your calendar.
In some cases, you may be prohibited from charging for certain elements of your work. For example, charging clients a fee for providing referrals is commonly prohibited. Before putting these fees or any others into your fee schedule, make sure you’re clear on applicable law and professional ethics codes in your area.
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