Free tool for therapists
Sliding scale fee calculator for therapists
Set your full fee and your lowest fee, pick your tiers, and get a fair sliding scale you can share with clients. Free, and nothing is stored.
Your client’s details never leave your browser. We don’t see or store them.
What is a sliding scale fee?
A sliding scale fee is a set of lower session fees a therapist offers to clients who cannot afford the full fee. The fee “slides” with what a client can pay, usually based on household income and sometimes household size.
Most practices keep a small number of reduced-fee spots and a clear rule for who qualifies. That keeps the practice sustainable and keeps the scale fair, because every client who uses it is measured the same way.
Sliding scale example for a therapy practice
Here is a sliding scale for a made-up practice with a full fee of $160, a lowest fee of $80 and 4 tiers, set by the federal poverty guidelines.
| Household size | Tier 1: $80 | Tier 2: $105 | Tier 3: $135 | Full fee: $160 |
|---|---|---|---|---|
| 1 person | up to $23,940 | $23,941 to $31,920 | $31,921 to $39,900 | over $39,900 |
| 2 people | up to $32,460 | $32,461 to $43,280 | $43,281 to $54,100 | over $54,100 |
| 3 people | up to $40,980 | $40,981 to $54,640 | $54,641 to $68,300 | over $68,300 |
| 4 people | up to $49,500 | $49,501 to $66,000 | $66,001 to $82,500 | over $82,500 |
Annual household income. Based on the 2026 federal poverty guidelines.
How to set up a sliding scale for your therapy practice
- Decide your full fee. Start with the fee you charge a client who pays in full. Every other tier is measured from it.
- Decide your lowest fee. Pick the lowest fee you can accept and still keep your practice running. Be honest about this number, because it is the one you will live with.
- Choose how many tiers. Three to six tiers works for most practices. Fewer tiers are easier to explain, and the tool spreads your fees evenly between your lowest and full fee.
- Choose how the tiers are set. Use the federal poverty guidelines, which adjust for household size, or type your own income bands. The tool builds the fee chart as you go.
- Decide how many spots and how you confirm income. Use Step 3 to see how many reduced-fee spots fit your income goal, then choose whether clients tell you their income or share a document.
- Put it in writing and share it. Download the fee schedule as a PDF, copy the table for your website, and copy the policy paragraph so every client hears the same thing.
Poverty guidelines or your own income bands?
The tool offers both. The poverty guidelines are the 2026 figures from the U.S. Department of Health and Human Services, and your own bands are income ranges you type in.
| Poverty guidelines | Your own income bands | |
|---|---|---|
| Household size | Built in. A bigger household gets higher income limits. | Only if you build it in yourself. |
| Where the numbers come from | A public federal table, so it is easy to point to. | You choose them, so they can fit your area. |
| Upkeep | The numbers change each January. | They change when you change them. |
| Best for | Practices that want a clear, outside reference. | Practices that know their community and want something simple. |
How many sliding scale spots should you offer?
Step 3 does the arithmetic. You enter how many sessions you see in a week, how much you want to earn, and your full fee. The tool takes the average of your reduced fees and works out how many of those sessions can be at a reduced fee before the week falls short of your goal.
For example, with 20 sessions a week, a goal of $2,800 and a full fee of $160, the four-tier scale above leaves room for about 7 reduced-fee spots. That is an example of the arithmetic, not a target.
Whatever number you land on, it helps to pick a fixed number of spots and stick to it. When the spots are full, a waitlist or a referral to a colleague is kinder to everyone than quietly stretching your own limits.
Confirming income: self-reported or documents
Some therapists take a client’s word on household size and income. It is quick, it respects the client, and it keeps paperwork out of a first call. The cost is that you have less certainty about who is using your reduced-fee spots.
Others ask to see a document, such as a recent tax return or pay stubs. That gives more certainty, but it can feel invasive, and some clients will not have the paperwork to hand.
Either choice is fine. What matters is that you pick one, tell clients up front, and treat everyone the same way. The policy paragraph in the tool writes out whichever one you choose.
Sliding scale and the Good Faith Estimate
A client on your sliding scale who pays out of pocket is still a self-pay client. They should get a Good Faith Estimate that shows the fee they will actually pay, so put their reduced fee on the estimate, not your full fee.
Our Good Faith Estimate template fills in the CMS model form for you, and you can type in whichever fee applies to that client.
If you take insurance
If you are in network with insurance companies, check your payer contracts before you discount for clients who are using their insurance. Some contracts have rules about charging insured clients different fees, and the rules differ between payers.
When in doubt, ask the payer or a billing professional. A sliding scale is most often used for clients who pay out of pocket, and this page is general information, not legal or billing advice.
Common sliding scale mistakes
- Too many tiers. Six is the most the tool offers, and more than that is hard to explain or keep fair.
- No review date. Incomes change, so say how often you will check, such as every 6 months.
- No cap on spots. A fixed number protects your practice and your other clients.
- A lowest fee below what is sustainable. If you dread a tier, it is too low.
- Not putting it in writing. A fee schedule and a short policy mean every client hears the same thing.
Frequently asked questions
Yes. The calculator is free to use and there is no sign-up. You build your scale, download or copy it, and keep it.
No. Everything is worked out in your browser, and the household size and income you type in Step 2 are never saved or sent anywhere. If you tick the box, only the settings in Step 1 are saved, on your device, and you can clear them at any time.
It uses the 2026 poverty guidelines from the U.S. Department of Health and Human Services, which took effect in January 2026. There is one table for the 48 contiguous states and DC, and separate tables for Alaska and Hawaii. HHS updates the guidelines each year, so the tool is updated each January.
The tool offers three to six. Three or four tiers are easy to explain and keep fair, and more tiers add choices without adding much help for clients. You can change the number at any time and the fee chart updates.
That is your choice. Taking a client’s word is simple and respectful, and asking for a document gives more certainty. Pick one, tell clients up front, and apply it the same way to everyone.
It depends on your payer contracts, which can limit how you charge insured clients. Check your contracts before you discount for them, and ask the payer or a billing professional if you are unsure. A sliding scale is most often used for clients who pay out of pocket.
No. This is a tool and general information, not legal, financial or billing advice, and we are a marketing agency, not a billing service. Check your fees and policies with a billing professional, your licensing board or an accountant if you are unsure.
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