Sliding Scale

“Expect the best. Prepare for the worst. Capitalize on what comes.”
~ Zig Ziglar

Offering a sliding scale is a way to extend services to clients who may not be able to afford your full rate, or who may not be able to attend as often as would be helpful. That said, in order for you to meet your budget, you need to also have full pay clients.

Before you begin to see clients, you need to determine answers to the following questions.

What is the rate/s for your sliding scale?

I find most people offer a tiered sliding scale with two or more different rates (if they offer one at all). It could look like this:

Full rate: $110 – Sliding scale top tier: $100 – Sliding Scale bottom tier: $90

You should decide on what your sliding scale options are prior to seeing clients, or at least prior to the initial discussion with clients.

How many sliding scale clients could you see in a week?

If your entire caseload is sliding scale clients, unless you increase hours worked, you will not make your budget. This is how many therapists burn themselves out. You need to leave room in your schedule for full-paying clients and not overload your week with clients who cannot help you sustain your business financially.

Consider how many sliding scale clients you could see in an average week and still meet your budget needs? How many people you can take at each tier?

Across you entire caseload, you will need to create a cap for how many sliding scale clients you are seeing at each tier. If you know what you limit is, it helps ease anxiety when having to potentially turn people away and refer them to others because you are already at your capacity for sliding scale clients.

What are the criteria for receiving a sliding scale fee?

In my experience, if you advertise a sliding scale, everyone will want to be on it. You need to figure out how you will determine if someone is suitable for your sliding scale. What information would you need from clients to determine this?

How often will the fee be discussed?

All client’s financial situations change, so it is recommended that if you have someone on a sliding scale, you create a schedule for when you will revisit their situation – it could be quarterly, bi-annually, annually. This allows protection for you and accountability for your clients. If someone wasn’t working, but now has found a great job, they may no longer really need a sliding scale, so the change needs to be addressed.

It is recommend that you let clients know in advance the time frame that you are agreeing to the sliding scale, and when it will be reassessed.

Business Tip

Make sure that when you write the receipts for clients on your sliding scale, you show that the price they pay is a discounted rate from your full rate.

For example: If your regular rate was $120 and a client was only paying $90, you could write it like this.

$90 ($30 discount – reg. $120)

This addresses a few things:

1) It reminds your client that they are not paying your full rate, they are on your sliding scale.  Clients tend to value the services more when they see they are getting a deal.  

2) If they refer a friend to you, they can correctly tell them what your regular rate is so they are setting expectations around rates appropriately.

3) It is a reminder for you at how much you are discounting your services and for who. Sometimes we can forget how many people are not paying full-rate. Writing it out on each receipt can be a helpful reminder if your caseload has become skewed and you need to start gathering some full-pay clients to make your budget and maintain your practice,