Twelve clients, nine different fees
You offer a reduced fee to students, people on low income and some long-standing clients whose circumstances changed. It is a big part of why you practise the way you do. The trouble is that each rate was agreed in a first session or an email, and it lives in your head.
When you raised your standard fee last year, you meant to keep concession clients on their old rates. You are fairly sure you did. A client asks why their invoice went up, and you realise one concession was missed. Another client has been on a student rate since they graduated two years ago, and you have never found a comfortable moment to review it.
Why concessions become hard to manage
Sliding scales are personal by nature. Each is agreed with one client, often in a sensitive conversation, and recorded informally. Over time the practice ends up with many different fees and no single record of why.
- Rates agreed verbally, with no note of the date or the basis.
- Standard fee increases applied by hand, client by client.
- No reminder to revisit a rate agreed for a temporary situation.
- Associates in a group practice setting their own concessions with no oversight.
- Concession places you meant to limit, with no count of how many you have.
What informal concessions cost
| Issue | Effect |
|---|---|
| Wrong rate invoiced | An awkward correction and a dent in trust |
| Reviews never happen | Temporary concessions become permanent by default |
| No count of concession places | More reduced-fee work than the practice can sustain |
| Inconsistency between associates | Similar clients paying very different amounts |
| Fee rises applied by hand | Hours of checking and some mistakes |
None of this is about charging people more. It is about the concessions you choose to give actually being the ones you give, and being able to sustain them.
How we record and apply agreed fees
- Each client's record carries their agreed fee, the date it was agreed, the category (for example student, low income, long-standing) and a review date if you want one. No personal financial details are needed.
- Invoices and payment links pick up the agreed fee automatically, from Xero, QuickBooks or Stripe.
- When you change your standard fee, you choose which categories move with it. Concession rates stay put unless you decide otherwise.
- Review reminders reach you, not the client, a few weeks before the date, so you can decide how to raise it, or not.
- A simple overview shows how many concession places are in use, by category and by associate, against any limit you set.
In a group practice, the practice lead can see concessions across all associates and agree a shared policy, while the conversations stay with each therapist.
We avoid storing income or benefit details. The category is enough to apply the fee, and anything more personal stays in the conversation where it was shared.
After it is set up
You raise your standard fee in one step, and concession clients are unaffected unless you choose otherwise. Invoices are right first time. When a review date comes round, you have a gentle prompt and time to think about how to raise it.
You can also see, honestly, how much reduced-fee work the practice is carrying, which makes it easier to protect it rather than quietly cut back when money is tight.
Does this sound like your practice?
- You offer sliding scale or concession fees.
- Agreed rates are not written down in one place.
- A concession client has been invoiced at the wrong rate.
- Temporary concessions have never been reviewed.
- You do not know how many reduced-fee places you currently offer.