Sunday, March 19, 2017

Tips for Setting Fees in Private Practice

After turning down an opportunity for a another set of contract classes that I had run in the past, I thought this would be the perfect time to talk about how important knowing your worth is and how to set fees based on that. It is hard to put a price on the service provided as a Dietitian. I want to help people and almost feel guilty charging too much and losing a client; however, at the same time, I rely on my business for income now. I have changed my fees multiple times in the past few years, so today's blog is going to guide you through my thought process and give you tips for setting your own fees (for individual sessions + classes).

Research Dietitians in Your Area
One of the first things I did when trying to figure out what to charge for counseling sessions was to see what other RDs were charging near me. A few did not list their fees on their website (I will talk about this in other blogs); however, the majority were in the $120-$175 range for an initial 1-hour consultation. I ended up going a bit lower since I had just started my practice and didn't have a masters degree or specialty certification yet.

Factor in Expertise + Education
As I mentioned earlier, I low-balled my initial fees for counseling; however, after getting my masters and having my practice for a year or two, I bumped up my fees to match what others charged in my area. When setting your hourly rate or counseling fees, think about your education, experience, certifications, etc. Your knowledge and level of experience is adding to the value that the client receives in the session (or class).

Base off of Insurance Fee Schedules
If you are a provider for insurance companies, you will have a flat rate that they will reimburse you and that changes slightly from initial to follow-up visit for MNT. You can use the rate that insurance reimburses for self-paying clients or choose to make that a little bit lower since they are paying out-of-pocket. The fee schedule for insurances helped me to alter my pricing a bit.

Triple Your Hourly Employee Rate
Something else I thought about when setting fees for counseling was determining what I was paid hourly when I was an employee and multiplying that by 3. Three seems arbitrary; however, I thought that 1/3 goes to me, 1/3 to taxes, and 1/3 to time spent on prepping. This can just help to give you that baseline rate to build from.

Offer Packages + Add-ins
When I think about my initial counseling fee, I also factor in what other "service" I bring to the session. Will the session include bio-metrics? Will I calculate nutrient needs? Will this be an in-home visit or office-based visit? If your initial session is simpler, you can charge a bit lower for the hour and have add-ins that clients can choose from. Say they want menu planning help, that can be added for an extra $60 (or whatever you will charge). Maybe they want a nutrient analysis done for their current meal plan, that can be an extra $50 or so. I also find it helpful to offer packages to clients.

Note About Charging for Classes
The classes were the hardest for me to determine rates for; however, I found the formula below to help me:
Start with Base Rate - $100/hr (I base this off of my flat counseling rate)
+ Travel Expenses - $.50/mile
+ Parking Fees
+ Prep Time/Lesson Development - $40/hour
+ Cost for Supplies/Handouts

When I determine how I am charging for a class, I alter it on a case-to-case basis. My base rate my be lower or higher depending on if this is an ongoing class or a one-time seminar. If I am driving for more than 30-minutes, I may also add in a fee based on the time spent in my car. Parking may be free for some classes/areas; however, others tend to be $20 just for the hour, so this will change too. If I created lessons on this topic before, I may charge $30 or $40/hour for prep time. If this is a new topic or the client wants it to be more involved, then I may charge $50 or $60 for the hour of prep. Lastly, I factor in a few dollars based off of how many handouts I needed. If I am providing a cooking class, I estimate the amount of food needed and will have another fee added to the pricing.

There are so many ways that you can calculate fees for classes. I have often charged a flat rate (lower than $100) and then added in a cost per person ($20/head) with a minimum number required to run the class. Charging for classes will definitely vary per client/company. For some non-profits, I have accepted a lower rate for a one-time class in exchange for them distributing my business cards or keeping me on a list as a dietitian. It is ultimately up to you to decide what you feel the most comfortable charging.

Final Tips
Setting fees for individual clients and group sessions is often difficult. One of the key things I have learned is really knowing your worth and not being afraid to walk away from something. I have had companies/organizations try and take advantage of my services. I even had one goes as far as guilt tripping me into thinking I was a monster for trying to charge even 1/3 of what I normally do. I am all about giving back to my community and providing free programs/seminars. What I need to be careful of is keeping the balance between free and paid work. I often think about if doing something will open doors for me or create opportunity. If the answer is yes, I will provide a free service (i.e. lunch n' learn for a company I may partner with, teaching in a school for the day, etc). If the answer is absolutely no (or slim), I rethink my decision. After all, one of the reasons I went into private practice, which I am sure may be the reason for many, is having the ability to choose your own destination.

Leave a comment and let me know if this blog was helpful to you in determining how you will set fees for your practice. Was there something else you thought about that I didn't mention?

Stay tuned for my next blog that will break down billable hours + setting income goals.

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