Survey: Amid economy concerns, 4 in 10 therapists plan to raise rates in 2024

Four in 10 therapists are planning to raise their fees in 2024, a new survey has found.

Heard, a bookkeeping and accounting firm for therapy practices, surveyed more than 2,260 therapists across all 50 states and D.C. The findings were published in a report on the financial state of private practices. It found that half of therapists are somewhat or very concerned about the economy impacting their practice in the coming year.

At the same time, in last year’s report, 64% of therapists said they were planning to raise their fees in 2023. Yet only a third did.

“One possible explanation is inflation and rising interest rates,” Michael Fulwiler, director of brand at Heard, told Fierce Healthcare in an email. “Therapists may have been worried about losing clients by raising their fees.” 

Three-quarters of therapists, up from 55% last year, reported making less than $100,000 in gross income from their practice in 2023. A fifth reported making less than $25,000. Similarly, 89% of therapists reported making less than $100,000 in profit from their practice in 2023, and nearly a third made less than $25,000. 

The number of therapists making more than six figures in profit dropped year over year by 27%. And more than 40% of therapists generated income from non-therapy sources, with supervision, teaching, speaking and consulting being the most popular. Heard expects that trend to continue as the creator economy grows, per the report.

Three-quarters of therapists also offer sliding scale fees or pro bono sessions. “Despite being underpaid and the cost of living going up, therapists still care about making their services accessible,” Fulwiler wrote in his email.

Despite cash pay popularity, three-quarters of therapists still accept some form of insurance. Aetna was the most common payer with which therapists paneled, followed by Cigna, Blue Cross Blue Shield, Anthem and Oxford. Aetna also had the highest average reimbursement rate at $141 per session, while Humana had the lowest at $96. 

Nearly half use a service like Alma or Headway for billing, while 18% did their own. About half also file taxes with the help of a tax pro, while nearly a quarter do it by themselves. 

“The financial state of private practice in 2024 is cause for concern,” the report said. And the burden of making therapy accessible “shouldn’t be on therapists,” it said. “It should be on insurance companies and the mental healthcare system.”