What is a Sliding Scale? Therapy Payment Options Explained

by Zencare team

When searching for a therapist, you might see the phrase “sliding scale” listed on their profile under payment options. But what does it mean? We’ve collected all of the information you need to know about the sliding scale payment type to make it easier for you to find a therapist that not only fits your needs but your budget as well!

What is sliding scale?

When a therapist offers a sliding scale, they’ve created a payment system that asks a client to pay based on their ability to do so - those who make less money pay less money for their therapy. So, as an example, if a therapist normally charges $150 for a session, a client who only barely meets the federal poverty income level could potentially pay 20% of the session fee, which is $30.

While it’s widespread for therapists to offer sliding scale payments, each therapist has different rates and thresholds for their clients.

How do I know if I qualify for a sliding scale payment system?

Therapists generally develop standardized rates of sliding scale payments for their practice and have a sliding scale chart available for clients to review. If you’re worried about paying for therapy and fitting the costs into your budget, ask your therapist (or prospective therapist!) if they have a sliding scale option. Because sliding scale is based on income, be ready to discuss how much money you make and your budgetary limitations with your therapist.

What are the benefits of paying on a sliding scale?

There are many benefits of using this payment system! Here are a few to consider:

  • Lower therapy costs. By nature of this payment method, those who have a tight budget due to a limited income can save money by paying less for their sessions.
  • Confidentiality. Because you aren’t using insurance to pay for therapy, the only people that will know that you’re in therapy are the people that you tell - there will not be a record on your insurance. This is especially helpful if you’re on your parents’ insurance or a partner’s insurance and you don’t want them to know about your therapy.

What are the downsides of paying on a sliding scale?

Unfortunately, there are also some downsides to paying on a sliding scale. Here are a few to keep in mind:

  • Limited therapists. Not all therapists offer this type of payment plan, so be aware that some therapists might decline to offer you a sliding scale option. (But don’t take it personally!)
  • Limited sessions. Some therapists who offer sliding scale might offer a limited amount of sessions for each client. Again, don’t take it personally! This is based off of the therapist’s client-load and ability to keep their business going while still providing quality care.

Is sliding scale right for me?

To decide if paying on a sliding scale is best for you, consider the following:

  • Your budget. If you aren’t able to afford therapy fees because of a limited and lower income, paying on a sliding scale might be beneficial to save money.
  • Your insurance. If you have insurance, check your Summary and Benefits to see if your plan will cover your therapy costs at a lower rate. If you don’t have health insurance, sliding scale might be a great option for accessing mental health services!
  • Your therapy goals. If you hope to access specialized services (such as Eye Movement Desensitization and Reprocessing) for a longer period of time, finding a way to pay outside of a sliding scale might be best as it may be difficult to meet your therapy goals if your sessions are limited or if your therapist’s availability changes.

If you think that paying on a sliding scale might be helpful for you, Zencare makes it easy to find a good fit!