Rates & reimbursement
How to price sessions in a group therapy practice
Start with what you collect per completed session, separated by service and payer. Then work out what each session needs to contribute toward clinician pay, overhead and the practice’s cash needs.
Independent Practice Advisors · 5 min read
Start with collections
Take a recent set of completed sessions that have had time to be paid. For each service and payer, divide the total collected (including the client’s share) by completed sessions. Compare like with like: individual therapy and testing can have very different economics. Keep the month of service and month of deposit separate so a slow payer doesn’t look like a low-paying one.
Review insurance plans side by side
For each plan, write down visit volume, dollars collected per visit, days to payment and the work it takes to resolve unpaid claims. Then estimate what remains after clinician pay and direct costs. Start with high-volume plans where a small rate change would matter, and consider how any change could affect existing patients’ access to care.
Put a cost beside each session
Subtract clinician compensation, related employer costs and payment fees. What’s left pays for rent, admin, software and other fixed costs. A session that brings in $125 and costs $75 in clinician pay and related costs leaves $50 before shared overhead. With $20 of shared costs per completed visit, it leaves $30. These are illustrative figures.
Test the proposed change
Model a $10 private-pay increase on 80 completed visits a month. If visits hold, collections rise $800 before any change in pay or fees. If eight visits are lost and the old price was $150, collections fall from $12,000 to $11,520. Also model the costs you’d avoid on those visits. Look separately at insured visits, where contract terms shape what can change.
Leave the meeting with a decision
Pick one service or payer to review. Bring its current collections, clinician cost and visit volume. Agree on the price to test, who it applies to, and when to check completed visits and collections again. For insurer rate requests, bring your current fee schedule and renewal date.
Nothing here is legal, tax, accounting or compliance advice. Keep your accountant and your attorney. We don’t provide HR advice.