I’m going to be frank here: setting the right fee schedule for your clinic is important—like, really, really important. Why is it such a big deal? The answer might seem obvious, but it’s actually a bit more nuanced. When new patients step into your office, you’re not just improving their day-to-day function—you’re showing them the value of their health and well-being. By seeking out movement-based therapy, patients are making an investment in their physical welfare. So, as a rehab therapy provider, are you investing in yourself by charging what you’re worth? Setting a fair and reasonable rate schedule tells your patients not only that your services are worth the price of admission, but also that rehab therapy as a whole is worth every penny.

WebPT Outcomes - Regular BannerWebPT Outcomes - Small Banner

Contending with a Cash-Based Model

Your clients come to you because you’re amazing at what you do, and the byproduct of your expertise is their ability to live healthy, active lives. But, it doesn’t matter how skilled you are—if you aren’t generating enough revenue to pay the bills, you won’t be in business for very long.

It seems like a no-brainer: the amount a clinic charges for services is a big part of what makes that business a success. And if you have a cash-based practice, it’s especially crucial that you charge enough to keep the doors open.

Avoid the “volume-over-value” trap.

“Can’t I charge less and just see more patients?” you might argue. Your willingness to accept lower rates and jam-pack your schedule is coming from the right place—you got into this business to help people, after all—but consider this: the burnout that often follows is just as damaging to your business as an inadequate patient load. Provider burnout can be the kiss of death for even the most earnest of rehab therapists, because it threatens the quality of care. And ultimately, patients pay the price.

Crunch the numbers.

The bottom line: It’s all about balance. Just because you can see 15 patients in a day doesn’t necessarily mean you should. According to private practice owner Ann Wendel, PT, the key is determining how many patients you need to see in order to:

  1. meet your financial goals, and
  2. continue bringing your A-game to each session.

As you define your financial goals, be sure to consider how much revenue you need to cover your overhead costs, taxes, and other expenses. Add this amount to your take-home goal to determine the gross income necessary to keep your practice (and yourself) financially healthy.

Now, here’s the fun part. Once you’ve calculated your gross income goal, divide that by the number of weeks you plan to work in a year, factoring in vacation and personal leave. The number you get is your weekly gross income. Then, divide that amount by the number of patients you can realistically see in a week. The resulting amount is the average per-visit out-of-pocket cost for your cash-pay patients. By calculating this number—and projecting the types of services you expect to provide on a weekly basis—you can get a good idea of where your service rates should be.

Know your market.

It’s also vital to know the lay of the land. These days, it’s not difficult to find out what your competition is charging, on average, for an office visit. Resources such as Glassdoor and City Data can provide information on the general cost of rehab therapy services in your locale.

It’s a beautiful day in the neighborhood! And knowing basic demographic information about that neighborhood can tell you a lot about how you should price your services. For example, the cost of therapy services is likely a little steeper in high-income areas, so you may benefit from keeping your rates on the high end—as long as you can offer the kind of high-value services that justify those rates.

If your practice is in a low-income area, you might want to consider a strategy that incorporates working with insurance panels. Remember: You don’t need to hang on to insurance panels that don’t meet your clients’ needs—or measure up to your reimbursement rates. What matters is that you position yourself according to the demands of the area.

Skip the sliding scale.

Of course, if your practice is cash-based, then it’s especially pertinent that you find a happy medium for your fee schedule as opposed to working off a sliding scale. According to this article from the APTA, “it is recommended that you bill based upon a single fee schedule for all of the services that you provide.” That said, if you wish to make your services accessible to low-income individuals, then you might consider developing a need-based discount structure to better serve that client base.

Download your 2018 State of Rehab Therapy report now.

Enter your email address below, and we’ll send you a free comprehensive report on the trends shaping the future of the industry.

Please enable JavaScript to submit form.

Initiating an Insurance-Based Model

Stick to one fee schedule.

Things can get pretty dicey when you’re dealing with insurance companies. Some practices opt to set up fee schedules for individual payers in order to maximize their reimbursements. However, creating a separate fee schedule for each payer can be a time-intensive task that yields minimal reward. In fact, according to this article, the APTA doesn’t recommend using multiple fee schedules at all. “It is much harder to justify your fees to a payer if you have multiple fee schedules. A better approach would be a single fee schedule, and then apply fee discounts based on your arrangements with payers.”

This single fee schedule philosophy also applies to self-pay patients who opt to pay for services on their own—without involving an insurance carrier. It might be tempting to create a separate “self-pay” fee schedule, but trust me—this can quickly turn into a billing nightmare. In some cases, it could even be considered unethical. A better option—and one that many providers choose to implement—would be setting up discount structures for patients who wish to pay out-of-pocket.

Set your sights high.

So, then, what should your fee schedule look like? Some clinics base their fee schedule on their regional Medicare fee schedule. But, applying Medicare’s rates across the board certainly won’t help you maximize your reimbursements, and you’ll likely be leaving money on the table. As this post from the Medical Group Management Association states, “to make sure fee schedules are maximizing reimbursement from payers, make sure that they are set above the allowable amounts for each payer, for each charge.”


As with most matters concerning payment for medical services, determining your pricing structure can be tricky business. But, you certainly don’t have to go it alone. If you’re still not sure how to determine your fees, there are plenty of business and consulting services that can help. In the end, it’s all about knowing your worth. And, as your patients start to see their health improving, they’ll know you’re worth it, too.

  • The Dos and Don’ts of Working With Insurance Companies Image

    articleJul 7, 2017 | 6 min. read

    The Dos and Don’ts of Working With Insurance Companies

    In 2016, Forbes reported that doctors spend more than 66% of their time on paperwork. And a good deal of that paper-pushing is insurance-related. There’s no denying that working with insurance companies is a challenging—yet required—part of running a rehab therapy clinic. One of the biggest hurdles in this professional relationship is negotiating contracts. Most medical professionals have at least heard a story of a nightmare negotiation that led to nothing but frustration. Ultimately, insurance companies usually …

  • Founder Letter: 3 Ways Your Practice is Losing Money Image

    articleMay 5, 2016 | 7 min. read

    Founder Letter: 3 Ways Your Practice is Losing Money

    Much like the patients you treat, your practice can appear healthy on the outside despite significant internal issues. And when those issues are money-related, the consequences can be deadly. If your practice already is in the red, you know you’ve got some pretty serious cash flow problems. But even if you’re in the black every month, you may still be washing dollars down the drain. While there are myriad ways your practice might inadvertently be losing revenue, …

  • Bad Debt Blues: How to Keep Your Clinic Out of the Red Image

    articleSep 21, 2018 | 5 min. read

    Bad Debt Blues: How to Keep Your Clinic Out of the Red

    Many practices are experiencing higher levels of bad debt than they have in the past—partially due to the proliferation of high-deductible health plans that place greater financial responsibility on patients. And when patients don't pay the full amount they are responsible for—and practices fail to collect past-due amounts—the go-to solution often is writing off those totals as bad debt. But financially, that is not an ideal course of action. So, let's talk about how to optimize your …

  • What's the Right Payer Mix for Your Practice? Image

    articleJul 17, 2018 | 6 min. read

    What's the Right Payer Mix for Your Practice?

    Insurance payments for healthcare services have been declining for a while now , which means providers in all disciplines are looking for ways to optimize their payer mix in order to maximize their revenue. If you haven’t yet calculated the cost of providing your services—and compared that number to the payments you’re receiving to ensure you’re actually making enough money to not only cover those costs, but also turn a profit—then you should. But the question remains: …

  • Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans Image

    webinarFeb 23, 2017

    Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans

    Copayments, coinsurances, unresolved balances—oh my! Any one of these can cause headaches for healthcare providers, but as healthcare reform efforts shift more and more financial burden to insurance beneficiaries, today’s practitioners are increasingly facing all three. And these challenges are not only hurting their patient acquisition and retention rates, but also their bottom lines. Tired of spending time verifying benefits only to lose those patients to copay sticker shock? Stuck in a constant cycle of pursuing past-due …

  • Common Questions from Our Patient Sticker Shock Webinar Image

    articleMar 31, 2017 | 33 min. read

    Common Questions from Our Patient Sticker Shock Webinar

    From copays and deductibles to payer contracts and benefits verification, understanding all the nuances of third-party insurances is tough enough for healthcare providers—let alone their patients. In WebPT’s most recent webinar— Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans —co-hosts Heidi Jannenga, PT, DPT, ATC/L, the cofounder and president of WebPT, and WebPT CEO Nancy Ham provided a lot of great advice on how to have productive conversations about healthcare costs with your patients—without …

  • Cashing In on Private Pay: The PT's Guide to Going Out-of-Network Image

    webinarJul 27, 2017

    Cashing In on Private Pay: The PT's Guide to Going Out-of-Network

    For many rehab therapists, submitting a claim to a third-party payer feels a lot like pulling the lever on a slot machine. You never know for sure what you’re gonna get—and most of the time, it’s less than you’d hoped for. With seemingly ever-increasing regulations—and constantly shrinking reimbursements—it’s no wonder so many PTs, OTs, and SLPs feel like the financial odds are stacked against them. [video://fast.wistia.net/embed/iframe/c49leax8yk] As a result, more and more rehab therapy providers are trying …

  • 4 Keys to Keeping a Steady Cash Flow Image

    articleMay 18, 2016 | 5 min. read

    4 Keys to Keeping a Steady Cash Flow

    As a private practice clinic owner, you’re probably familiar with the cold sweat-inducing struggle to keep a steady cash flow. Claims management muck-ups, inefficient processes, staff issues, and lack of insight into your clinic’s financial health can leave you feeling like you’re riding a revenue rollercoaster. So, whether you’re trying to maximize reimbursements , combat employee theft , or optimize patient payments , these four keys to maintaining a steady cash flow will help you even out …

  • Get Wellness: How to Boost Your Therapy Practice’s Revenue with Cash-Based Services Image

    articleJun 14, 2017 | 5 min. read

    Get Wellness: How to Boost Your Therapy Practice’s Revenue with Cash-Based Services

    There’s a pesky rumor flying around the healthcare industry: the more successful your treatment plans, the less business you receive from your existing patients. When you get down to it, the prime directive for most rehab therapists is to improve the health of the patient until he or she no longer requires therapy. And from the patient’s perspective, the quicker his or her health improves, the happier he or she will be with your service—and that often …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.