Hey Doc Anthony,

I was hoping I could pick your brain a bit regarding hiring a few part time folks at my practice. My thinking originally was to give a set percentage for each session that the licensed counselor performs but now for ease of payment I was thinking a flat hourly rate per session. Another agency in the state pays $30.00 per session regardless of the type. I personally never made more than $23 an hour working for someone else, but it was a full time job and offered benefits. I was considering $30 per regular session and $40 per group. In the future when we could afford it, we would then start hiring fulltime with benefits.
What are your thoughts? Any information would be greatly appreciated as this in NOT my area of expertise at all (I design programs and practices but have not been involved with HR related stuff).

I see you are burning up the pages of CT. Glad to have a guaranteed good read!

Take care and thanks again for the offer of help and guidance! (the offices should be sheet rocked in the next week or two!)

Hi John,
Of course I’d be happy to help.

There are really no “right” answers as it comes to this sort of thing.
Counselors do tend to prefer a flat rate over a % split, because they don’t need to worry about money coming in from clients or insurance companies. That being said, it seems that most small practices pay their licensed clinicians on a split. For independent contractors, a typical split is often 60%/40%, in the licensed clinician’s favor. Some practices pay more, and some pay less.
And some–like Thriveworks–pay their clinicians as employees (not independent contractors) and absorb a 7.65% payroll tax in addition to compensation fess paid. And offer benefits. Ouch. Perhaps, instead of looking at what you pay per appointment, it would be best to look at whether someone could make a good living working with you.

That’s going to keep your practice competitive, and help you to retain a good team. Losing a clinician is REALLY HARD on a practice, so you want to make sure that your clinicians are not going to depart to pursue better compensation elsewhere.

I have encountered too many practices that lose their best clinicians every couple years or so because they pay under market rate. These practices can recruit new clinicians, but most of them–at some point–decide to leave. This can hinder a practice’s growth and long term success. That said, I see just as many practices pay their clinicians too much (typically over 60% as employees, or over 65% as contractors). These practices never seem to have any money to grow the practice, because too much of their revenues are tied up in staff compensation.

I hope this helps John!!


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