How to Set Your Private Practice Fees

Most practitioners set their private practice fees by asking what others charge, picking something that feels close, and hoping the numbers work out. There's a way to do this that can be a little more concrete, and it starts with your capacity ceiling.

💡 Your capacity ceiling is just what it sounds like: the actual number of sessions you can hold in a week without running yourself into the ground. This is not the number you could theoretically fit into the schedule, but one accounting for everything else in your life.

Work backwards from there to what each session needs to pay. When you work in that order, your rate goes from being guesswork to some actual solid math.

Why copying the market rate usually isn't enough on its own

Looking at other therapists' rates is a reasonable starting point. It can give you a ballpark, tell you what clients in your area are used to seeing, and help you avoid pricing yourself wildly out of range, but on its own, it usually doesn't get you where you need to be.

A rate doesn't exist in a vacuum, someone charging $180 a session might be running 25 sessions a week with minimal demands outside work. If your life outside the clinic means 10 sessions is your real ceiling, their number doesn't translate to your situation. You'd be borrowing the output without the context behind it.

If the fee isn't covering what your practice and your life actually cost, the math doesn't work. And no amount of seeing more clients fixes it if more clients will push you past what your capacity can hold. Market rates can tell you where the neighbourhood is, but they can't tell you what your floor needs to be.

Fee-setting and capacity is something Ashley Comegys, a licensed clinical social worker and private practice business coach, helps her clients work through all the time. She walked us through her framework in a recent Behind the Practice session, Intentional Practice: Designing a Business That Fits Your Life, and we've laid it out below.

How to set your private practice fees from the inside out

Step 1: Name your capacity ceiling

How many sessions can you actually hold each week, including everything that happens after those sessions: admin, documentation, the Tuesday afternoon when you have a personal commitment. This isn’t the number you could theoretically fit in if everything went perfectly, if four sessions a day is your real number, that's your number.

Step 2: Name your income floor

Your income floor is the minimum monthly take-home that keeps your life and your practice running without strain. What do you need each month to hit that number? The real figure, not a polished guesstimate, but what actually covers expenses, taxes, a bit of breathing room, and doesn't leave you relying on side work to fill the gaps.

Step 3: Run your numbers

Your rate floor is the minimum per-session fee that keeps your practice financially viable. To find it, take your monthly income floor and divide it by the number of sessions you can realistically hold in a month.

Say your income floor is $4,000/month and your honest session capacity is 40 sessions/month. That puts your rate floor at $100 a session. Anything below that and the math stops working, regardless of how full your schedule looks.

Your private practice session rate needs to be at or above that number.

If those two figures feel mismatched, there are a few paths forward: raise the rate, reduce expenses, or specialize more tightly so each session carries more value. What usually doesn't work long-term is squeezing more sessions into a week that's already full.

Four things you can adjust when the math isn't working

Ashley's framework for sustainable private practice design comes down to four connected decisions. Pull on any one, and the others shift.

Schedule. Your client hours, yes, but also the days you work, the hours you're available, how many back-to-backs you can actually hold, and making sure you've room for a life outside the clinic.
Caseload. How many clients, how often, at what intensity. There's a difference between a full caseload and an overloaded one, and 8 hours of sessions every day, all week, is usually the latter.
Fees. This is where most practitioners have the most room and the most hesitation. The fee has to make the math work given the caseload ceiling. If the math isn't mathing, adjusting your schedule alone won't fix it. This is true whether you're billing insurance, running a private pay therapy model, or somewhere in between.
Systems. The admin, documentation, and billing that pile up invisibly. Sorting these out won't magically open up more appointment slots, but you might find a few hours in your week you didn't know you were losing.

Figure out your real schedule first, then build your caseload around that. Set a fee that makes the math work, then put systems in place so none of it quietly falls apart.

How to raise your private practice fees with existing clients

Fees aren't really something you set once and forget about. As your costs change, your experience grows, or your capacity shifts, your rate needs to move with them.

The straightforward part is knowing when the numbers no longer work. The harder part is communicating that change to clients, especially those who rely on benefits coverage to access their sessions. A few things that help:

Give notice well in advance. A few weeks of runway means the client has time to process it, ask questions, and sort out their coverage before the new rate kicks in.

You don't have to move everyone at once. Some practitioners bring new clients in at the updated rate while existing clients get a smaller, incremental increase.

Offer whatever options you genuinely have. For US-based practitioners, a superbill lets clients seek partial reimbursement from their insurer. For Canadian practitioners, coverage limits vary by province and plan, and being upfront about what that means is usually more helpful than hoping it works out.

And if the conversation feels uncomfortable, come back to the math. But know the math is in service of something bigger too. A practice that's financially stretched means you, as a practitioner, feel stretched too. Getting your fees right is how you protect your ability to do the work well and show up for your clients.

Frequently asked questions

I'm fully booked but still not making enough. What am I missing?

Usually it's the rate, not the schedule. A full caseload and a sustainable private practice income aren't the same thing, and more sessions won't close the gap if the per-session rate isn't covering expenses, taxes, and a reasonable take-home. It can be useful to run your collected revenue divided by your session count over the last few months to find your actual effective rate per session. If that number is lower than what you're charging, write-offs, no-shows, or sliding scale spots may be quietly pulling it down.

How do I tell existing clients about a rate increase?

Keep the message short and grounded: the new rate, the date it takes effect, and what to do with questions. You don't need to over-explain or apologize. Most clients take it better than practitioners expect, especially with a few weeks' notice. If you're honouring a legacy rate for long-term clients while new clients pay the updated rate, say that clearly upfront so there's no confusion at checkout.

How do I stop accidentally booking past my real capacity?

If you're using practice management software, your shift structure can be something you explore here. If your honest capacity is four sessions a day, set your availability to cover exactly those hours and nothing more. Clients can't book outside your available hours in online booking, so the shift itself becomes the ceiling. Blocking off breaks after the fact or relying on willpower to stop taking bookings are workarounds. Building the right availability window from the start is the system.

Is it okay to charge new clients more than existing ones while I increase my private practice fees?

Yes, and it's common. Keeping long-term clients at a previous rate while new clients come in at your current rate is a reasonable business decision. If a client asks, the honest answer is simple: new clients come in at the current rate, and existing clients are at the rate they started. Don’t feel you need to apologize for this either. The transition period shouldn't last indefinitely, though. The goal is to move the whole practice toward a rate that actually works, not to maintain two permanent tiers indefinitely.