Private Pay Dreams, Insurance Realities: A Therapist’s Guide to Strategic Growth
There’s a lot of talk in therapy spaces about “just going private pay.”
And if you’ve been in the field long enough, you’ve probably heard things like:
“You’re worth more than insurance rates!”
“Just set your fees and the right clients will come!”
“The best practices don’t take insurance at all!”
This sounds good. Until you remember you’ve got student loans, dependents, and a mortgage. Maybe you’re the sole provider in your household, or at least you feel like it. Suddenly, the idea of dropping insurance feels less like a bold move and more like a reckless choice.
Let’s be honest: the shift to private pay isn’t just a business decision, it’s an emotional one. A strategic one. A life-altering one. It’s serious and it’s not something that you should feel ashamed of taking time to decide on.
The Pressure to Go Private Pay
When you’re surrounded by therapists online talking about waitlists and $200 sessions, it’s easy to start questioning yourself:
If everyone else has figured this out, WHAT am I doing wrong?
How much longer do they expect me to wait for my money?
Can I make it without insurance?
But here’s the thing: staying with insurance panels doesn’t make you less than. And going private pay doesn’t make you elite.
Both are models. Both require strategy. And neither one guarantees ease or profit. What matters is what YOU want, regardless of what it looks like at the practice around the corner.
Why “Just Drop Insurance” Doesn’t Work for Most Therapists
The private-pay push is often sold like it’s a mindset problem. But even if your money mindset could use a tune-up that’s not the only or even the most important issue. Many therapists want to go private pay because of the stress or logistics of billing a third party payor, but philosophically it doesn’t feel good to potentially put a strain on patients, Maybe you’re not sure who your perfect client is yet or maybe you like working in multiple niches. And of course, without the consistent referrals from being listed on insurance panel directories, you take on more of the marketing pressure to find clients on your own.
A Bridge, Not a Leap
For most therapists, I encourage a combined model, including both clients from select insurance panels AND clients who are self-funded or private pay. For our practice that includes clients who pay from their own HSA/FSA funds, some who choose to use CareCredit and others who are funded by our work with our corporate partners.
Let’s talk about how you can craft your private-pay inclusive practice.
What does that look like?
✅ Knowing your numbers, so you’re not relying on vibes. This includes not having more than 20% of your gross revenue from any one source. (This is a goal, so don’t feel bad if you’re not there yet.)
✅ Testing premium services before cutting ties with insurance. This is where your 5-6 figure consulting contracts can come in handy.
✅ Designing offers that respect your life, not just your license. I use digital products and intellectual property, like book sales to get paid while I sleep.
✅ Creating a consistent marketing strategy that brings your best clients directly to your door without the insurance panel directories.
What makes this easier? Having a strategic thinking partner who’s not going to give you a one-size-fits-all plan that doesn’t fit your values, your vision, or your real life.
If that is something you’ve been looking for, check out the Q1 Kickstart Program. Just like my strategy sessions, you get my ONE-ON-ONE time looking at your goals and dreams and we can craft a plan that keeps your bills paid now on the way to whatever your long term goals are.
In the Q1 Kickstart we’ll look at your most logical and easy to implement plan for generating cash pay clients fast, including the possibility of corporate partners, then I’ll audit your digital footprint so you know exactly what to do to attract the clients that you want on repeat.
Whether you want to be 100% cashpay or have a hybrid model, I can help you get there. Check out the Q1 Kickstart today.