What is a sliding scale fee?
Sliding scale fees refer to the range of session fees that a therapist is willing to accept for clients with limited resources.
For instance, while a therapist's standard session fee might be $150 per session, they may list a sliding scale of $80 - $150. This means that when possible, they will work flexibly within your budget and offer lower fees to help you receive mental health care.
When can I ask for a sliding scale fee?
You can ask for a sliding scale at any time, starting with your initial call with a therapist. You can also ask about a sliding scales if you've been seeing a therapist for a period of time and your health insurance changes; they might be more likely to work within your budget if they already have an established relationship with you.
It's a good idea to think about your therapy budget and do some research ahead of time. You may want to look at what their standard fee is, as well as what other therapists in the area typically charge to get a sense of what you can reasonably ask.
Just be aware and try not to take it personally if your request is declined. Whether a therapist offers a sliding scale at any given time depends on how many of their clients are already paying low fees, and it can’t hurt to ask a few therapists for this option.
What are the pros and cons of sliding scales?
Benefits of sliding scale fees
- Lower fees: Depending on personal circumstances, some therapists can be very flexible with sliding scale fees.
- Greater privacy: Bypassing insurance entirely ensures greater privacy; information about your sessions won't be reported to the insurance company, which means if you are on your parents' insurance, they won't find out, and future insurers won't have access to your therapy history.
- No need to meet deductible: You don't have to meet your deductible before paying reduced fees.
Limits of sliding scale fees
- Limited slots: Therapists typically have a limited number of sliding scale slots, so your request could be declined, or negotiated to more than you want to pay. While they may reserve a few sliding scale slots for clients who would not otherwise be able to seek therapy, these slots are typically limited; not all clients can pay the lowest limit fee at any given time.
- Lower limits to sliding scale: Therapists typically list a lower limit in order to ensure they earn a livable annual salary.
- No contribution to deductible: Sliding scale fees do not contribute to your deductible, so if you have major medical expenses later in the year, you will have higher upfront costs before your insurance coverage begins.
- Potential change in your therapist's circumstances: While this is less common as therapists try to accommodate existing clients, if your therapist's circumstances change, they may require an increase in fees and no longer be able to accommodate your sliding scale fee.
Find therapists who offer sliding scales
Find therapists who offer sliding scale fees below. Try reaching out to two or three therapists, in case your preferred therapist’s sliding scale slots are full.