How to set your therapy session fee

Why “what others charge” is the wrong starting point

Local rates are useful information, but they tell you nothing about your own situation. A colleague may work four days a week from a room they own, while you rent by the hour and work three days alongside a part-time job. They may have fifteen years of client referrals; you may be building from zero. If you copy their fee without copying their cost base and caseload, you are copying the wrong half of the equation.

Start from the inside instead: what you need to earn, what your practice costs, and how many sessions you can realistically deliver in a year. Only then compare the result with the market, and adjust.

Step 1: list every cost of running your practice

Employees rarely see these costs, so new practice owners tend to underestimate them. Go through a full year and write down everything, including the items you pay once a year and easily forget:

Also decide what you want to take home in a year after all of the above. Be honest and include holidays, sick days and saving for a pension — as a self-employed therapist, nobody else will do it for you.

Step 2: count the sessions you can really deliver

This is where most fee calculations go wrong. A full-time employee might assume 46 working weeks of 40 hours. A therapist cannot see clients for 40 hours a week and stay well. Work it out in steps:

1. Take 52 weeks and subtract holidays, public holidays, training days and a realistic allowance for illness. Many therapists end up with 42–44 working weeks.
2. Decide how many client sessions per week you can hold without your quality slipping. For many therapists this is somewhere between 15 and 25, depending on the work and the rest of their life.
3. Subtract sessions that will not happen: late cancellations, no-shows and gaps between one client finishing and the next starting. Planning for 80–90% of your capacity is more realistic than 100%.
4. Remember the unpaid hours: notes, emails, invoicing, supervision and marketing. They do not change the sessions count, but they explain why your hourly rate has to be higher than an employee’s.

A worked example (illustrative figures only)

The numbers below are invented to show the method. Your costs, taxes and target income will be different, so replace every figure with your own.

The result is a floor, not a target. Below it, your practice is quietly subsidised by your savings or your partner’s income. If the floor comes out far above what clients in your area pay, that is useful too: it tells you to lower costs, add sessions, or position yourself differently — before you discover it a year in.

One question to settle early with an accountant is VAT. In many European countries, psychotherapy and other healthcare services are exempt, but the rules depend on your profession, your registration and the kind of service — coaching, for example, is often treated differently. Whether your fee includes VAT changes the calculation, so check your national rules.

Step 3: compare with the market and position yourself

Now look at what therapists with similar training charge in your area and online. Directory profiles and practice websites usually list fees. Ask yourself where you fit:

• Specialisation. A clear focus (for example trauma, couples work or a specific age group) usually supports a higher fee than a general offer.
• Experience and qualifications. Years of practice, accredited training and supervision roles are legitimate reasons to charge more.
• Format and location. City-centre rooms cost more and clients expect that in the fee; online sessions may let you keep costs lower.
• Languages. Offering therapy in a language few local practitioners speak is a real differentiator for expat and international clients.

Pricing well below the market rarely fills a diary faster. Clients choosing a therapist look for fit and trust first, and a fee that looks too low can raise questions rather than remove them.

Different session types, different fees

One fee for everything is simple, but it often hides work you are not paid for. Consider setting separate fees for:

• Intake or assessment sessions, which are often longer and involve more preparation and documentation.
• Couples or family sessions, which carry more complexity per hour.
• Longer sessions, such as 75 or 90 minutes for specific methods.
• A reduced-fee option for a limited number of places, if you want to keep therapy accessible. Decide the number of places in advance so it stays sustainable.

In PRAXINGO you can work with multiple session types, and on the online booking page (Pro plan) each service you offer has its own duration and price. The session timer offers to create the invoice when the session ends, so you are not reconstructing sessions from your calendar at the end of the month. See all features.

Put your fee and cancellation terms in writing

A fee only protects your income if your terms are clear before the first session. Your therapy agreement should state the fee per session type, when and how clients pay, and what happens with late cancellations and missed appointments — for example, that a session cancelled less than 24 or 48 hours ahead is charged in full. Check that your terms are compatible with your professional code and national consumer rules.

Automated reminders reduce the number of missed sessions in the first place; our guide on reducing therapy no-shows covers that in detail. PRAXINGO sends reminders 24 hours, 1 hour and 5 minutes before an appointment by email, and payment reminders for unpaid invoices, so you do not have to chase clients yourself.

When and how to raise your fee

Costs rise every year. If your fee stays the same, your income falls. A few habits make fee rises routine instead of awkward:

1. Review your calculation once a year, at the same time, with your actual costs and session numbers from the past year.
2. Prefer small, regular increases over a large jump after several years.
3. Give existing clients clear notice — one or two months is common — in writing, with the date the new fee applies.
4. Decide in advance whether long-term clients keep their current fee for a while, and apply that consistently.
5. Update your website, directory profiles and session types on the same day, so nobody sees two different prices.

Setting up your practice from scratch? Our step-by-step plan for starting a private therapy practice in Europe puts fee-setting in context with registration, insurance and data protection. And when you are ready to fill the diary, read finding more therapy clients without burning out.

Frequently asked questions