How Are Sliding Scale Fees For Therapy Calculated?

this is a drawing of an online therapy session

How are Sliding Scale Fees for Therapy Calculated?

Sliding Scale Therapy

Sliding scale therapy is a form of payment some therapists use to help individuals that can’t afford the rate scale of $80-$200 per therapy session. Seeking mental health help shouldn’t be unaffordable to any of the population, the sliding fee scale helps address this.

Here is How are Sliding Scale Fees for Therapy Calculated?

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In today’s blog, what is sliding scale therapy, I am going to share with you all you need to know about sliding scale therapy.  My goal is to give you all the information you need to decide what therapy choice is best for you, without confusing you in your mental health journey.

Sliding scale therapy is a fee structure that some therapists use to provide therapy at a lower cost for people who cannot afford standard therapy rates if their health insurance doesn’t cover it. With sliding scale therapy, treatment is priced according to an individual’s annual income and dependents, making therapy consistently more affordable for those living at a lower income level.

Therapists who employ a sliding scale for therapy costs help people who need therapy and don’t believe that an individual’s income should dictate whether or not they receive it. Overall, therapy rates seem high, even to those with higher incomes. The prices you typically see are overall not a reflection of greed or lack of ethicality among therapists. Instead, the prices they set reflect everything therapists must do to maintain their practice, including their insurance, continuing education courses, and taxes.

Therapists who want to help as many people as possible utilize sliding scale therapy as a legal, ethical, and practical way to make this possible. Take a second and type in “therapists near me” in google and email the first three choices asking them if they offer sliding scale therapy.

No matter what type of therapy you need, perhaps its reunification therapy with your estranged loved ones or a regular talk therapy session, it’s always good to go in with a plan.

How Are Sliding Scale Fees For Therapy Calculated?

Sliding scale therapy fees are calculated based on an individual’s income. The scale accounts for where your monthly or annual income falls in relation to the poverty levels in your state and national poverty levels. However, many therapists follow the yearly United States federal poverty guidelines to establish their sliding scale fees.

In other words, the less money you make each month, the less you would pay for therapy. Some therapists use a formula like (0.00) x (Annual Income) to set their fees.

There are trusted resources, legal experts, and worksheets that therapists utilize to ensure their sliding scale therapy fees meet ethical guidelines.

Here is some insight into how they calculate their prices and the lowest possible price per session they can offer:

  • They first assess the typical costs in their area – the “customary and reasonable rate.”
  • Then they calculate what it costs to run their practice annually.
  • Therapists will then decide the salary they hope to make or the lowest one they can set to live comfortably.
  • They add the annual costs and minimal compensation and divide that total by 12 to see how much income they 
need to bring in monthly.
  • From there, they find the average number of people they see monthly.
  • Finally, they divide their required monthly income by their number of monthly clients to find the minimum fee they can charge for a session and still maintain their therapy practice.

Your therapist will use this information to create their scale from which they will determine a fee with you and create a document that you both will sign. Some therapists will request proof of income, while others rely on their clients to be truthful in sharing their financial information. 
If your income changes anytime throughout your therapy sessions, you both may need to revisit the form and adjust as needed.

To better understand what you can afford to pay per therapy session, you first need to understand how often should you go to therapy.

What Is A Good Sliding Scale For Therapy?

A good sliding fee scale for therapy accounts for any financial challenges that impact your ability to pay for treatment. To effectively use sliding scale therapy, some therapists will set a fee for a specific income or range of incomes. 

For example, if you make between $30,000 to $40,000, you might be charged $40 or $50 per session; if you make $70,000, it might cost around $80 per therapy session. And those who make enough money to pay the full therapy cost will be charged that therapist’s standard fee. Someone making $120,000 per year or more can expect to pay at least $100 per hour-long session.

If you want to find out what you would be billed for sliding scale therapy based on your income, call or e-mail the therapist you want to work with and inquire. Note that most therapists who offer sliding scale therapy will not advertise it, especially considering that they rarely post their regular rates as is, so don’t be afraid to reach out and ask.

The optimal sliding scale therapy relationship is one where your therapist is willing to work with you through significant financial changes and hardships. In some cases, they may be able to lower the fee they previously set for you.

Alternatives To Sliding Scale Therapy

Sliding scale therapy is not the only way to make treatment more widely affordable. Here are a few alternatives to sliding scale therapy that you may come across or inquire about different therapy options:

1. Payment plans

Where offered, this is a route that some patients can take if they are in the midst of a temporary financial challenge hindering their ability to pay. Following a payment plan, you can expect to pay a small amount of your session fee weekly then pay your remaining balance once you are able.

2. Pay what you can

If a therapist allows clients to pay what they can, they may suggest a minimum payment or leave it entirely up to their client. Some therapists also offer a limited number of pro-bono sessions they can contribute each year.

3. Bartering

Bartering is an acceptable payment method as long it’s established ethically. So, if your therapist considers bartering, the value of the session and services or goods exchanged must be equal. Furthermore, therapists should not accept an exchange of anything pertaining to the reason you came to therapy in the first place. For instance, if you are already stressed due to a heavy workload, you would need to consider exchanging goods versus adding an hour to your current workload.

4. Group therapy

Group therapy is when multitudes of people go into one therapy session, this can be up to fifteen people at times. There also may be more than one therapist, and the cost will be reduced from a regular one-on-one session.

How Much Should You Pay For Therapy?

The average cost per session of an in-office therapy session starts at around \$65.00 but can go up to \$200.00 . Sliding scale aside, this is a price range to keep in mind when determining how much you should pay for therapy.

When searching for sliding scale therapy offerings, look for public or private non-profit mental health organizations. These clinics generally tend to offer lower rates more often than private practice therapists, one reason being that they receive charitable donations and state or federal grants. One last thing to consider if you need more affordable therapy is online platforms such as BetterHelp and Talkspace. The online therapy industry is growing and will get more affordable in time.

If you are struggling with your mental health and do not believe that your low-income level should keep you from getting the help you need, find a compassionate therapist who feels the same. Your options for affordable therapy and sliding scale therapy are out there.

Some areas you can find a therapist that has the sliding scale therapy option are cognitive behavioral therapy, online therapy, family therapy like structural family therapy, couples therapy and other counseling services.

Sliding scale therapy cost

The costs of a sliding scale therapy session depends on what your income is.

  • $30,000 – $40,000 income:  You might pay $40 – $50 per therapy session
  • $50,000 – $70,000 income: You might pay $60 – $80 per therapy session.
  • $120,0000 income: You will not fall into the sliding scale, and you will pay the standard rate.

Explore our favorite online therapy apps


BetterHelp is an online counseling platform connecting individuals with licensed therapists for convenient mental health support.
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An online therapy platform offering access to professional therapists for personalized and confidential mental health services from the comfort of home.
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Evidence-based therapy support through interactive worksheets, live sessions, and messaging with professionals.
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Sliding Scale Therapy Conclusion

Sliding scale therapy is a good option for you if you feel therapy is not affordable with your income. There are many ways to get help, allow yourself to choose one and let a professional work with you to help better your mental health.

There is a stigma around therapy, the thing is going to see a therapist doesn’t always have to be negative. There are many things things to work on in therapy.

To help counter the stigma around going to therapy I would love if you left a comment below saying you go to therapy.

Allowing others to see all of these comments will help others decide to go to therapy for their fist time.

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