Free tool
Build a sliding scale that doesn't sink your practice
Most therapists want to offer a sliding scale. Most sliding scales are built backwards: the generosity comes first, and the math comes later, usually in the form of a tight month and a quiet sense of resentment. The fix is not to be less generous. It is to decide, in dollars, what your generosity costs — and to choose that cost on purpose.
This calculator does the arithmetic for you. Enter your full fee, the lowest fee you can sustainably offer, and how many discounted slots you want to carry. You get two things: a clean fee ladder you can hand to clients, and an honest readout of what the scale costs you per week and per year. Read the full guide: sliding scale therapy fees, and if you are still setting your base rate, start with setting your therapy rates.
Completely private: everything runs in your browser — nothing you type is sent or stored anywhere.
1. Your numbers
Many therapists anchor near Open Path's $30-70 range. Below your true cost per session, it stops being a discount and becomes a subsidy.
Many therapists skip the income guide entirely and let clients choose their own band.
2. Your fee ladder
Sliding scale fee schedule
The middle fees are editable — click one to set the fee you actually charge.
The income framings are a rough guide, nothing more. Many therapists skip them entirely and simply let clients self-select the fee that is honest and workable for their household.
3. What it costs you
Curious how your average compares? See revenue per session.
Printed at the top of the PDF so the schedule reads as yours, not ours. Saved only in this browser.
The PDF is a one-page schedule you can hand to clients — bands only, none of your revenue math on it.
This calculator is for planning, not financial or legal advice. If you take insurance, check your payer contracts and state rules before discounting — insurers may constrain what you can charge for covered services.
Sliding scale questions, answered
How many sliding-scale slots should I offer?
Work backward from the number, not from guilt. Decide how much weekly revenue your practice needs to stay healthy, then see how many discounted slots fit inside that. Many full-time therapists land somewhere around 10 to 20 percent of their caseload, but the right answer is whatever your numbers can carry year after year.
What should my lowest fee be?
Low enough to matter, high enough to sustain. Many therapists anchor near the Open Path Collective range of roughly $30-70 per session. If a fee is below what a session actually costs you to deliver, it is not a discount, it is a subsidy — and subsidies need a budget.
Do I have to verify a client's income to place them on a band?
No. The income framings on the ladder are optional guides, not eligibility rules. Many therapists simply show clients the schedule and let them self-select the fee that is honest and workable for their household. Verification adds friction and awkwardness for very little gain in a small practice.
Can I use a sliding scale if I take insurance?
Carefully. Payer contracts often constrain what you can charge for covered services, and routinely discounting or waiving cost-shares can violate those contracts and, in some cases, state or federal rules. Sliding scales are simplest for private-pay clients. If you are in network, read your contracts and check your state rules before discounting.
Using it in your practice
Use this when you first set up a sliding scale and again any time you raise your full fee, since the whole ladder should move with it. Decide how many reduced-fee slots you can carry before a prospective client asks, so the answer on the phone is already settled.
Hand the fee schedule out at intake or post it with your fees, and write each client's band into their financial agreement. Keep a simple running count of the reduced slots you have filled. When they are full, new clients can join a waitlist instead of pushing the scale past what you can sustain.
Look at it again at year-end with whoever does your books. Check whether the actual cost of the scale matched the number you chose, and adjust the slot count or the floor from there.
What it does not do
- This is a planning tool, not financial or legal advice.
- If you are in network, payer contracts and state or federal rules may limit discounts or waived cost-sharing for covered services. Check before you apply a scale to insured clients.
- Self-pay clients on any band still need a Good Faith Estimate that shows the fee they will actually be charged.
- The income guides are rough. They are not a means test, and they do not account for local cost of living.
Read the guide
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