PhD/PsyD Fees for Private Practice

[Psych101grad]

I am currently an unlicensed postdoc looking for extra experience in private practice. I have been talking to a person who is creating a group practice and would provide supervision, space, and a full caselaod of referrals. Whats an apporpriate fee for an unlicensed postdoc in a big city with high end/no insurance clients? She offered $40 per session. I just was not sure if this is high, low, or something else. Thanks!

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[bcliff]

I am currently an unlicensed postdoc looking for extra experience in private practice. I have been talking to a person who is creating a group practice and would provide supervision, space, and a full caselaod of referrals. Whats an apporpriate fee for an unlicensed postdoc in a big city with high end/no insurance clients? She offered $40 per session. I just was not sure if this is high, low, or something else. Thanks!

What is the out-of pocket rate for the service? I would imagine that anyone paying out of pocket is paying at least $100 - $200 (unless they're on a sliding scale), so I would imagine your making between 20% - 40%. I'm not sure how competitive that is, but I've personally known unlicensed post-docs that have taken home roughly 30% of the out-of pocket rate for a specific service. Do you know what the cut would be bumped up to after you were licensed?

 

[erg923]

I am currently an unlicensed postdoc looking for extra experience in private practice. I have been talking to a person who is creating a group practice and would provide supervision, space, and a full caselaod of referrals. Whats an apporpriate fee for an unlicensed postdoc in a big city with high end/no insurance clients? She offered $40 per session. I just was not sure if this is high, low, or something else. Thanks!

We have have no way of knowing because you didn't tell us how much the practice actually charges the patient. If the rate is $80 per session then you are getting 50% split. Not bad for no overhead/footwork of your own. If a session is $200, you are getting royally ripped off, right?

 

[xXIDaShizIXx]

We have no way no way knowing cause you didn't tell us how much the practice actually charges the patient. If the rate is $80 per session then you are getting 50% split. Not bad for no overhead/footwork of your own. If a session is $200, you are getting royally ripped off, right?

This. We would have to know how much you were charging overall in order to give you fair advice.

 

[AcronymAllergy]

Agreed. Although in general, I'd imagine some PP folks would agree that taking a lower % of the charged rate in exchange for getting an actual full-time caseload from day 1 could be a sweet deal, particularly if the split improves once you're licensed.

 

[Psych101grad]

Thanks for the advice... So she herself charges $275 and thinks she would charge $200 for me (possibly less she was not quite sure she could charge that much). Also she said there would be an automatic bump up to $75 once I am licensed.

 

[bcliff]

Going from a 20% split ($40/$200) to a 27% ($75/$275) as a licensed psychologist doesn't seem like that great of a deal to me, and both of those cuts are less than ideal IMO. What type of services will you be offering at these rates? If you're going to be administering lengthy evaluations that require hours of (non-billable) report writing, then I would be a little wary of this arrangement.

How many billable hours will you be working per week? I recommend you figure that out and determine whether what you'll be making annually is enough to support yourself.

 

[erg923]

275 for a 50 minute therapy hour? Where are you? If you are ok with 20% split, go for it.

 

[Therapist4Chnge]

If you are unlicensed and she provides the required supervision hours towards licensure I'd think a 40/60 or 50/50 would be what I'd shoot for with "discounted" rates (not $200) for being a post-doc. Honestly, I'd be really surprised if she could get people to spend more than $75-$100/session for an unlicensed person. As for once you are licensed…anything less than 70%/30% is asking too much, and that includes the overhead w. an assistant to schedule/bill. Of course…if I were in her position, I'd ask for a more favorable split for my initial offer, though I'd understand someone not taking it and/or needing to negotiate a better split.

You should also inquire about any non-compete agreement, as I'd expect with her offer she probably has a pretty stiff non-compete too.

 

[erg923]

Going from a 20% split ($40/$200) to a 27% ($75/$275) as a licensed psychologist doesn't seem like that great of a deal to me, and both of those cuts are less than ideal IMO. What type of services will you be offering at these rates? If you're going to be administering lengthy evaluations that require hours of (non-billable) report writing, then I would be a little wary of this arrangement.

How many billable hours will you be working per week? I recommend you figure that out and determine whether what you'll be making annually is enough to support yourself.

Well, seeing that the modal number of psychotherpay sessions is 1 and that no shows are par for the course, he or she is looking at making $40 an hour with maybe 5 billable hours a day (and thats if the provider can keep the patient spicket running at full blast) before taxes, with no benefits (health insurance, paid sick/vacation, retirments accounts/investments). If you are working 5 days a week...thats some pretty yucky math.

I would think the receptionist for the practice would be doing just as well, maybe better...

 

[aequitasveritas]

I worked for a few group practices and in one of them all we really used was Medicaid due to the locale. I received $48/hr on a 55% split. The other group provided 50% of whatever the fee was; whether using insurance or cash.

Another thing to look out for is that folks starting group practices have a tendency to talk a big game to get things off the ground, and the reality usually falls far short of the pitch.

My private practice experience has included: a very busy and popular analytic practice on the west coast, a more community/Medicaid oriented group practice on the east coast, and now my own private practice in a very posh and wealthy town on the west coast again. In addition, I currently see the most expensive psychoanalytic therapist in my city. He charges just a smidge over 200.
Point being....you r NOT going to pull 275. That's insane of her to tell you that...literally...out of touch with reality. I don't have to know the geo region. This is not happening anywhere in the country for the most skilled licensed folks, let alone post docs.

I would be cautious of the potential implications of this persons' big pitch.

 

[xXIDaShizIXx]

I worked for a few group practices and in one of them all we really used was Medicaid due to the locale. I received $48/hr on a 55% split. The other group provided 50% of whatever the fee was; whether using insurance or cash.

Another thing to look out for is that folks starting group practices have a tendency to talk a big game to get things off the ground, and the reality usually falls far short of the pitch.

My private practice experience has included: a very busy and popular analytic practice on the west coast, a more community/Medicaid oriented group practice on the east coast, and now my own private practice in a very posh and wealthy town on the west coast again. In addition, I currently see the most expensive psychoanalytic therapist in my city. He charges just a smidge over 200.
Point being....you r NOT going to pull 275. That's insane of her to tell you that...literally...out of touch with reality. I don't have to know the geo region. This is not happening anywhere in the country for the most skilled licensed folks, let alone post docs.

I would be cautious of the potential implications of this persons' big pitch.

Yes, this job seems a bit fishy. Try to go for a higher split and see what they say and get back to us.

 

[erg923]

I worked for a few group practices and in one of them all we really used was Medicaid due to the locale. I received $48/hr on a 55% split. The other group provided 50% of whatever the fee was; whether using insurance or cash.

Another thing to look out for is that folks starting group practices have a tendency to talk a big game to get things off the ground, and the reality usually falls far short of the pitch.

My private practice experience has included: a very busy and popular analytic practice on the west coast, a more community/Medicaid oriented group practice on the east coast, and now my own private practice in a very posh and wealthy town on the west coast again. In addition, I currently see the most expensive psychoanalytic therapist in my city. He charges just a smidge over 200.
Point being....you r NOT going to pull 275. That's insane of her to tell you that...literally...out of touch with reality. I don't have to know the geo region. This is not happening anywhere in the country for the most skilled licensed folks, let alone post docs.

I would be cautious of the potential implications of this persons' big pitch.

Ha. I totally missed the part about "a person who is creating a group practice"....

Yea, dude. She is promising a fire hydrant of patients before the practice has even been established and expects to get $275. Its delusional. Do soemthing else.

 

[PhDMiss2014]

I'm currently an intern seeking a post doc and have had discussions with two group practices to date. One bills at $140 per hour and would offer $30 per hour with 25 billable hours per week guaranteed. The other bills at $180 per hour and would offer $60 per hour and does not guarantee any billable hours but believes 20 billable hours per week to be realistic. Not sure I'm going this route, still pursuing other options.

 

[PsyDr]

I recently had a manic patient write me a check for $23 trillion dollars. I would like to hire you to go cash this check for me. 20% split seem fair?

 

[erg923]

I'm currently an intern seeking a post doc and have had discussions with two group practices to date. One bills at $140 per hour and would offer $30 per hour with 25 billable hours per week guaranteed. The other bills at $180 per hour and would offer $60 per hour and does not guarantee any billable hours but believes 20 billable hours per week to be realistic. Not sure I'm going this route, still pursuing other options.

Personally I think 34k and NO benefits sucks, even for post-doc! I would actually try to avoid using PP for a post-doc.

 

[aequitasveritas]

I'm currently an intern seeking a post doc and have had discussions with two group practices to date. One bills at $140 per hour and would offer $30 per hour with 25 billable hours per week guaranteed. The other bills at $180 per hour and would offer $60 per hour and does not guarantee any billable hours but believes 20 billable hours per week to be realistic. Not sure I'm going this route, still pursuing other options.

I'm really not trying to b an overly critical reviewer here, but this is just not how PP works. Think...
There is no guarantee of billable hours in PP. Clients r free to no show, cancel, etc. This person is saying that even in the fray of cancellations he or she can just keep em comin, and for a post doc. No. There r clinics and community oriented Medicaid groups which can keep the spicket running, but at a the Medicaid insurance rate; not 140.
I also "charge $150". Most cannot pay that, and insurances pay whatever the eff they want.
Folks who can pay cash for therapy have the most skilled and seasoned shrinks to choose from. Trust me, the group referral provider may b able to persuade some to see you, but many , if not the majority , will sense that something is not kosher with paying 140 for a post doc, unless ur just crazy awesome-skilled beyond ur years.

 

[Sanman]

I would have to agree with all that is said here. Having done this on post doc, I have no idea how anyone can keep you filled. I was the only-postdoc in an in demand practice and I never kept more than a dozen clients in two days working there. My rates were $60-90/hr. A good split is 40-60% with most people I know coming in at ~50% unlicensed and a licensure bump to at least 70%.

 

[AcronymAllergy]

I'm really not trying to b an overly critical reviewer here, but this is just not how PP works. Think...
There is no guarantee of billable hours in PP. Clients r free to no show, cancel, etc. This person is saying that even in the fray of cancellations he or she can just keep em comin, and for a post doc. No. There r clinics and community oriented Medicaid groups which can keep the spicket running, but at a the Medicaid insurance rate; not 140...

Yeah, I'd be very cautious about the wording of the agreement. Are they basically just guaranteeing that they'll have you booked for at least 25 hours/week (of which, as mentioned, no doubt some proportion will no-show or cancel) and is this in the contract, or are they being crazy-generous and saying, "hey, if you don't get 25 hours' worth of work, we'll pay out-of-pocket to make up those hours." If somehow the latter is the case, that's awesome.

 

[Therapist4Chnge]

I would have to agree with all that is said here. Having done this on post doc, I have no idea how anyone can keep you filled. I was the only-postdoc in an in demand practice and I never kept more than a dozen clients in two days working there. My rates were $60-90/hr. A good split is 40-60% with most people I know coming in at ~50% unlicensed and a licensure bump to at least 70%.

Thanks for the info, as it is helpful to hear from people who actually went through this experience. Would you be able to put the region of the country so people have a bit of context w the figures?

I'm actually going over my fee schedule right now, trying to figure out what I'm going to charge for 2014, and then I can go to the insurance carriers and see if I can bargain an increase.

 

[Sanman]

Thanks for the info, as it is helpful to hear from people who actually went through this experience. Would you be able to put the region of the country so people have a bit of context w the figures?

I'm actually going over my fee schedule right now, trying to figure out what I'm going to charge for 2014, and then I can go to the insurance carriers and see if I can bargain an increase.

Upper middle class suburb in the Northeast outside of a major city. The other thing to consider; how are your hours being counted? If you are booked for 16hrs, but only see 8 due to cancellations, are they going to count you working for 8 or 16 hrs? If it is 8 hrs in that case, you could end up as a perpetual post-doc. Consider the opportunity cost.

 

[edieb]

Thanks for the info, as it is helpful to hear from people who actually went through this experience. Would you be able to put the region of the country so people have a bit of context w the figures?

I'm actually going over my fee schedule right now, trying to figure out what I'm going to charge for 2014, and then I can go to the insurance carriers and see if I can bargain an increase.

I am actually doing a 50-50 split right now. I bring in roughly $300/hour for 6 hours a day. My show rate is around 95 percent. Included in my contract are the fact that they hire the support staff (i.e., nurse, a receptionist and a clinical social worker to do the intake assessments), they own the building and pay all the utilities, and they do all the advertising and do all the billing. I actually consider myself very lucky because the owner of the building is a former billing manager for the inpatient psychiatric hospital in town and she knows exactly how to do the billing so it doesn't get rejected by the insurance company

 

[erg923]

I think you need to qualify the kind of work you do....

 

[paramour]

Personally I think 34k and NO benefits sucks, even for post-doc! I would actually try to avoid using PP for a post-doc.

Agreed. I'm fairly certain our MA interns make more than this (still without benefits).

 

[AlmostDone22]

I am currently working in private practice as a postdoc, in a neighborhood in a large, major city. I take 60%, my supervisor takes 40%. I also rent office space separate from this, as my supervisor has no space available for me. I decided to go with a very low rate for sessions, since my goal was to get my hours done. At this point, I am charging $50 a session (which means I take $30, before taxes and expenses). My percentage will increase, however, after I pass the EPPP. That might be something to look into, as well. It really stinks to be making so little money (and I am lucky that my partner's job actually pays enough in this city to make ends meet, which was not the case where we were for grad school). If I am working full time, however, it should be what I would be making at a formal postdoc. And while it has stunk, I do think it has helped me build up a clientele a lot quicker. My rate is really a lot closer to what people might pay as a co-pay if they are using insurance, so it is affordable for them. I am thinking about opening up a second office in the center of the city, if I do not get a job or a formal postdoc at a UCC for 2014-2015. If I do that, I am thinking I will want to charge more based on the area. I will likely do a sliding scale there, so people that can afford more pay more.