How to Set Your Rates (Even If You Take Insurance)

Let’s Talk About Fees (Without the Guilt)

If you’re building or growing a private practice, there’s one business decision that tends to bring up a lot of feelings: how to set your rates.

Whether you’re fully private pay, in-network with insurance panels, or somewhere in between, determining your fees isn’t just a financial decision—it’s also an emotional and ethical one. You want your services to be accessible. You want to serve your community. But you also want (and need) your practice to be sustainable.

Here’s the truth: You can honor your values and your worth. In this post, I’ll walk you through how to set your therapy rates—even if you accept insurance—so you can feel confident about your fees and focus on doing the work you love.

1. Start With Your Numbers

Before you think about “what others charge” or “what clients will pay,” you need to understand your business needs.

Ask yourself:

• How much income do you need to bring home each month?

• How many clients do you want to see per week?

• What are your monthly business expenses (e.g., rent, EHR, liability insurance)?

• How much time do you want to reserve for admin, notes, consultation, and time off?

Use this info to calculate your minimum sustainable fee. This is the lowest amount you can reasonably charge per session while meeting your goals. (Pro tip: build in a buffer for sick days, holidays, and slower seasons.)

2. If You Take Insurance, Know Your Reimbursement Rates

Accepting insurance doesn’t mean you can’t have a private pay rate—but it does mean you need to know the numbers.

• Look up your contracted rates for each panel you’re on.

• Compare those rates to your minimum sustainable fee.

• If your reimbursement is significantly lower, consider dropping panels that pay far below your threshold.

3. Set a Full Fee (Even If Most Clients Don’t Pay It)

Even if you’re in-network with insurance, you should have a clearly defined full private pay rate.

Why?

• It anchors your sliding scale (if you offer one)

• It helps you calculate out-of-pocket costs for OON clients

• It positions you as a professional service provider

Research therapists in your area with similar training, experience, and niche. Your rate doesn’t have to match theirs exactly—but it should reflect your expertise, costs, and value.

A common range for private pay therapy is $100–$250+ per session depending on location and specialization. It’s okay to start lower and raise your rates gradually as your confidence and experience grow.

4. Consider a Sliding Scale (Strategically)

Sliding scales can be part of an ethical, accessible practice—but they need structure.

Tips for offering one:

• Set a cap: e.g., 2-3 sliding scale spots

• Define clear criteria (income-based, temporary hardship, etc.)

• Reassess every 6 months

• Use a sliding fee schedule or partner with programs like Open Path

A sliding scale works best when it’s planned intentionally, not offered impulsively out of guilt or pressure.

5. Communicate Your Rates With Clarity and Confidence

You don’t have to write a full blog post explaining your fees (I’ve got that covered 😉), but you do want to be clear, kind, and direct.

Sample script:

“My full rate is $150 per 50-minute session. I’m also in-network with Aetna and Cigna. If you’re paying out of pocket, I may have a sliding scale spot available depending on current openings.”

Post your fees on your website or intake forms so clients aren’t caught off guard—and so you’re attracting clients who are ready to invest in themselves.

6. Give Yourself Permission to Reassess

Your rates aren’t set in stone. You can—and should—review them regularly.

✅ Are your current fees sustainable?
✅ Are you reaching your income goals?
✅ Has your experience, training, or niche grown in value?

Even small rate increases (e.g., $5–$10/year) can make a significant impact over time. Give clients notice, communicate transparently, and trust that the right-fit clients will stay.

Final Thoughts: You’re Allowed to Thrive

Setting your rates is more than a math problem—it’s a reflection of how you care for yourself, your business, and your clients. Whether you’re just getting started or adjusting your fee structure years in, remember this:

You deserve to be paid fairly for the care you provide.

You can run a heart-centered, ethical, and sustainable practice. You can serve your community and build a business that supports your life.

Want support figuring out your fees, panels, or systems?
I help therapists build values-based private practices that actually work—for you and your clients. Book a consultation and let’s create a plan that fits.

Related Articles: Should You Take Insurance in Private Practice? The Pros and Cons

Do I Need a Billing Service or Can I DIY? A Therapist’s Guide to Handling Insurance Like a Boss

How to Start a Private Practice Without Feeling Overwhelmed

Billing for Therapists: Making Sense of EOBs, Denials, and Rejections