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Have questions about private practice? View the FAQ page or participate in a free Q&A Teleconference on Private Practice, for members-only. We also maintain a listserv for social workers in private practice so you can ask business questions and seek consultation. Join for support and resource sharing.

Private Practice Handbook

  • I. Determining Legal Structure
  • II. Office Space
  • III. Marketing a Clinical Practice
  • IV. Practice Insurance

  • V. Private Pay Agreement

  • VI. Superbill Template

  • VII. Third Party Reimbursement

  • VIII. Preparing for an Audit

  • IX. Clinical Documentation

  • X. Retention of Records

  • XI. Electronic Medical Records

Leadership Ladder Series

Legal Defense Fund Series

NASW Practice Standards

Private Practitioners and Fee Agreements

One struggle social workers have when they move into private practice is structuring and maintaining a fee policy. The following provides you with some tips to reduce your risks. "Private social work practitioners can significantly reduce their risk of legal problems with written contracts" (Barker, 1992, p. 118), because in malpractice suites written substantiation may be the best defense.

Fee Setting and Bill Collection

Fee setting and bill collection should be addressed in client materials. An office sign summarizing the setting’s financial policy is useful. The service contract should be the client’s written consent to a fee agreement that has been discussed and agreed on. The fee agreement should:

  • State that the client should immediately advise the practitioner of difficulty with payment.
  • Indicate that payment of fees will first involve efforts to resolve the payment problems and may lead to termination of services and collection efforts allowed by state law.
  • State the policies on forms of payment accepted, third-party payments, sliding fee scales, charges for missed appointments, payment due expectations, consequences of nonpayment, bartering and pro bono work, and fee splitting.
  • Remember to review financial policies with clients, especially in cases where the client is in crisis on their initial visit. It will be difficult for them to remember all the information provided and it is important to review this as well as other policies and expectations at follow-up sessions.

What fees should I charge?

Fees vary and are influenced by several factors, including geographical location, fees of other mental health professionals who provide psychotherapy services in the area, and reasonable and customary fees that insurance companies set. There is no legal or professional requirement regarding the amount to be charged. Conduct a survey of psychotherapy fees in your area, and decide on an amount that is fair and reasonable for your practice. Contact NASW Ohio Chapter if you are interested in connecting to other private practitioners in your area. The Ohio Chapter seeks to be a conduit for linking members of similar interests and areas of practice.

Forms of Payment

Does the setting accept cash, checks, money orders, or credit cards as forms of payments? If you are interested in setting up a merchant account to accept credit cards contact NASW Ohio Chapter at 614-461-4484 for information to assist you. Does the setting accept third-party payments, or are clients asked to pay first and await reimbursement from the insurance company? Clients should know that third-party payers may limit service sessions. Contact NASW Ohio Chapter at if you are interested in purchasing the guide, Third-Party Reimbursement for Clinical Social Worker Services.

Sliding Fee Scales

Stated criteria or the fee schedule and required documentation to establish qualification. Sliding fee schedules have costs and benefits. The cost may be the invitation for bargaining and negotiating struggles that may continue as the service progresses. The Ohio Counselor, Social Worker, and Marriage and Family Therapist Board’s rules do not allow bartering of services. Contact the Board at 614-466-5465 or find information at their website.

Charges for Missed Appointments

How does the practitioner charge for sessions that are delayed and thus shortened because of the client’s late arrival? Are clients charged for missed session, with or without notice from client? How much notice is required for client to avoid being billed for a missed session? An understanding with the client of their responsibility of a missed appointment when a third-party payer does not reimburse for missed appointments. Signage in the waiting room on payment policies and missed appointments are good reminders to your clients of your reimbursement policy.

Payment Due Expectations

Clearly outline when payments are expected. If and what type of credit is extended with clients being billed later, or is their requirement for clients to pay when services are rendered? 

Where and When to Conduct the Business of Financial Payment

Most private practitioners have only one office area without support staff to handle the financial matters of the practice. In this setting have a small place away from the therapy area, possibly a desk and two chairs where you can address finances with the client. The recommendation of many in the field is to take care of finances prior to the therapeutic session instead of at the end. Speak with other practitioners about how they handle their payments to gather lessons learned from the field.

R. L. Barker (Ed.), Social Work in Private Practice (2nd ed., 104-115) Resources and References
NASW Professional Review & Ethics Adjudication Office (202) 336-8231

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