Pricing is the part of private practice that gets decided in five minutes and then lived with for years. It deserves an afternoon, because a price set slightly too low does not show up as a crisis — it shows up as a full diary, a tired practitioner and a year that somehow did not pay.
Why copying the clinic down the road goes wrong
Local rates are useful information. They tell you what patients in your area are used to paying, and drifting far outside that range needs a reason you can explain in a sentence.
What they cannot tell you is whether that number works for you. The clinic charging less down the road might see thirty-five patients a week in a room they own, with a receptionist who fills cancellations. You might be renting a room by the hour, seeing eighteen, and doing your own admin at nine in the evening. The same price produces two completely different years.
The symptom of a price set by imitation: a diary that is full, patients who are happy, and an income that does not match the effort. If you are working more than you planned and earning less than you hoped, the problem is almost never demand.
The number nobody counts: billable hours
This is where most pricing calculations fall apart. People divide what they need to earn by the hours they intend to work, and the hours they intend to work are not the hours anyone pays for.
Take a nominal forty-hour week and subtract the honest reality:
| Where the week goes | Typical |
|---|---|
| Nominal working week | 40 hours |
| Notes, reports, letters | − 4 to 6 hours |
| Admin, invoicing, chasing payment, messages | − 3 to 5 hours |
| Gaps the diary never filled | − 2 to 4 hours |
| Late cancellations and no-shows | − 1 to 3 hours |
| Sessions actually delivered | 24–28 |
Then take the year. Fifty-two weeks minus holiday, public holidays, illness and a conference or two leaves something like forty-four working weeks. At twenty-six sessions a week, that is roughly 1,150 sessions a year — not the 2,000 that “forty hours a week” suggests.
Everything in your pricing depends on that number, and getting it wrong by a third is the single most common reason a practice underprices itself.
What a session actually costs you
Write down every cost the practice has in a year, whether or not it feels like a business cost:
- Room or clinic rent, or the room percentage if you work inside someone else’s clinic.
- Professional registration, insurance, indemnity and any association fees.
- Equipment and consumables, including the replacement of things that wear out.
- Software, phone, internet, accountant.
- Continuing education, which is not optional in this profession.
- Travel between sites or to patients.
- Marketing, if you spend anything at all.
- Tax and social contributions, which are not a cost exactly, but come out of the same money.
- Unpaid time off: holiday and sick leave that nobody pays you for.
Divide the annual total by your real session count and you have the part of every session that is already spent before you earn anything.
Working out your floor, then your price
The arithmetic is short:
- The income you need, after tax, to live on. Start from your actual life, not an aspiration.
- Add tax and contributions at whatever your rate is.
- Add the annual costs from the list above.
- Divide by real annual sessions. That is your floor — the number below which you are working for the privilege.
- Add a margin for the year that goes wrong, the equipment that breaks, and the fact that you would like the practice to be worth running.
Then, and only then, look at local rates. If your floor sits above what your area pays, you have three levers rather than a dead end: reduce costs, increase the number of sessions you can deliver, or change what you offer so the comparison is no longer like for like. Quietly accepting a price below your floor is the one option that does not work.
Packages, blocks and when a discount is worth it
A package of sessions paid in advance is the most useful pricing tool in private practice, for reasons that have nothing to do with the discount:
- Attendance improves. A patient who has paid for six sessions turns up for six sessions.
- The transaction leaves the treatment room. Nobody is getting a card out at the end of a session about their back.
- Cash flow becomes predictable, which matters more to a small practice than almost anything else.
- The course of treatment is framed properly — as a plan with an end, rather than an open-ended series of visits.
What you should not do is discount heavily. Ten per cent for a block paid up front is plenty; twenty-five per cent means four patients on packages earn what three used to, and you are busier. And be clear in writing about expiry, transfers and what happens to unused sessions — those conversations are unpleasant precisely because the rule was never written down.
Home visits, insurers and the awkward cases
Home visits have to carry the travel. Either a higher session fee with a defined radius, a distance band added to the fee, or a minimum booking for far addresses. An hour in the car is an hour of your working day and it comes out of your session count.
Insurer and scheme work pays a set rate you do not control, so the question is not what to charge but how much of your diary to give it. Predictable volume at a lower rate can be worth it; a diary that is entirely scheme work at a rate below your floor is a slow problem.
First sessions usually take longer and involve a full assessment and a written plan. Charging the same as a follow-up is a choice — make it deliberately rather than by default.
Concessions are legitimate and worth deciding in advance: a fixed number of reduced-fee slots, a defined criterion, and a normal price for everyone else. What erodes a practice is not the concession, it is the case-by-case negotiation that has no rule behind it.
See the price per session in your own numbers
Session prices, packages, what has been paid and what is outstanding — in one place instead of three spreadsheets.
Create a free account → No credit card. The first 7 days have no limits at all.Raising your price without losing your patients
The fear is that patients will leave. Some will. In practice it is fewer than expected, and it is rarely the ones you want to keep.
What makes an increase go smoothly:
- Make it small and annual. A modest yearly adjustment reads as normal. A large jump every four years reads as a different service.
- Give notice. Four to six weeks, in writing, with the date it takes effect.
- Honour what is already paid. Packages bought at the old price stay at the old price. This costs little and prevents every argument.
- Do not over-explain. “From 1 March, sessions will be X” is enough. A paragraph of justification invites a negotiation.
- Do not apologise. Everything else your patients buy went up this year too.
Saying the number out loud
The last obstacle is not arithmetic. Plenty of physiotherapists can calculate a correct price and still find it hard to say, especially to a patient in pain.
Two things help. Put the price where it is read before anybody speaks to you — on the website, in the booking confirmation — so the number is already accepted by the time you meet. And when you are asked directly, answer with the number and stop: “Sessions are X, and the first one is a full assessment and lasts an hour.” No justification, no discount offered pre-emptively, no trailing off. The silence after a price is meant to be there.
How Physioly handles pricing
What the system does: a price per session you can set per patient, packages with the number of sessions bought, used and remaining, payments recorded against each patient, an outstanding-balance list, receipts and PDF reports, and a financial view of what came in over a period. If you charge one patient differently from another — a concession, a scheme rate, a home-visit fee — that lives on the patient record rather than in your memory.
What it does not do: it will not calculate your floor for you, it does not model scenarios, it does not raise prices automatically or adjust them for inflation, and it does not take card payments — it records that a payment happened. The arithmetic in this article is yours to do once; the system’s job is to make sure the result is applied consistently to every patient afterwards, which is the part that fails when it lives in a spreadsheet.
Questions we get asked
How much should a physiotherapist charge per session?
Enough to cover your costs and your unbillable hours at the number of sessions you can realistically deliver each week. Local rates set the range patients expect, but they cannot tell you whether that range works for your room, your hours and your overheads. Work out your own floor first, then position yourself inside the local range — not the other way round.
How do I calculate my hourly rate as a self-employed physiotherapist?
Take the annual income you need, add your annual costs and your tax, then divide by the number of sessions you can actually deliver in a year — not the number of hours you work. A forty-hour week is rarely more than twenty-five to twenty-eight billable sessions once notes, admin, cancellations and holidays are removed.
Should I offer discounted packages of physiotherapy sessions?
A package is worth it when it changes behaviour: paid in advance, it improves attendance, removes a payment from every visit and makes your cash flow predictable. A discount that simply lowers the price of sessions the patient was going to book anyway is money given away. If you offer one, discount modestly and require payment up front — that is what you are being paid for.
How often should a physiotherapy clinic raise prices?
A small annual review beats a large occasional jump. Patients absorb a modest yearly increase as normal; the same rise delivered once every four years feels like a different service. Whatever you decide, apply it on a date, announce it a few weeks ahead, and honour packages already paid for.
Should I put my prices on my website?
Yes. Price is one of the first things a prospective patient wants to know, and hiding it costs more enquiries than it protects. People who would not have booked at your price filter themselves out before they take up your time, and the ones who ring have already accepted the number.