Standard 6.1: Fees

The College does not set the fees that registrants may charge for services. However, a registrant may not charge or accept a fee that is excessive or unreasonable in relation to the service provided. Registrants also may not offer a discount or rebate to a client for prompt payment of fees, nor charge more than the registrant’s usual fee for a service where a third party is paying for the service.

Registrants may accept payment on a sliding scale, i.e., variable fee depending on ability to pay. Registrants must ensure that clients are aware of their fee schedule before commencing services and are required to provide an itemized account of services, upon request.

Registrants may provide free initial consultations without further obligation, and must provide the service promised, and as advertised. For example, registrants must not offer an “hour” of therapy assuming that clients know this means 50 minutes. If a registrant chooses to increase their fees, they shall provide reasonable notice to clients and should not discontinue therapy because a client cannot afford the higher fee.

If a client fails to pay a registrant in accordance with agreed-upon terms, this is not grounds for immediately discontinuing services. While the registrant is entitled to be paid for their services,  they must place the needs of the client first. Before discontinuing services for non-payment, the registrant should advise the client of alternative services/service providers that are accessible to the client. At the start of the relationship, if applicable, the registrant shall make sure the client understands that they are required to pay for services, and that services will be discontinued if payment is not received.

While registrants are permitted to use the services of a debt collection agency in order to recover unpaid fees, they are prohibited from selling or assigning client debts. This does not prohibit registrants from accepting payment by credit card.

Registrants are expected to create and adhere to fee schedules; however, there may be cases where clients are unable to pay the full posted rate. In the interest of equity, registrants are permitted to offer fee reductions in accordance with set policies. For example, a “sliding scale,” may be appropriate for low-income clients.

Registrants must not unduly restrict forms of payment. For example, if a client does not have a credit card, the registrant should explore if another method of payment is feasible. Conversely, registrants should not charge clients more for paying by credit card, for example by passing on the credit card processing fee to the client.

Forms of payment should be appropriate with regard to the type of therapy practice. For example, it would be reasonable for an RP with an electronic practice to generally require electronic forms of payment (e-transfer, or credit card).

Bartering with clients should be a last resort due to the risks involved, and in all but extraordinary cases would not be appropriate. Bartering inherently creates a boundary crossing and dual relationship, which puts the client at risk. In many cases there are alternatives to bartering, e.g., sliding scale, or pro-bono work, that may promote the same equity considerations. In communities where bartering is the norm, registrants must be careful to apply safeguards should they barter their services. This includes, but is not limited to, contracts detailing the method and value of payment, careful consideration of the conflict of interest being developed, strict documentation of conversations surrounding the method of payment, and conversations with the client around mitigating the conflict of interest and dual relationship that may be developed through bartering.

Block fee arrangements are permitted if registrants adhere to the expectations set out in Standard 6.1.6. Registrants  use caution in offering block fee arrangements. Registrants must not pressure clients to continue in treatment because they have paid up front and take care to ensure clients do not feel an obligation to continue until the predetermined end date. If a client ends treatment partway through the prepaid sessions, registrants  refund fees for services not yet provided. RPs are expected to provide refunds within seven days of the initial request.

If a registrant agrees, either verbally or in writing, to provide a course of therapy for a regular set fee or a negotiated fee, the registrant must fulfill this commitment to the client. This does not preclude a registrant from raising fees with proper notice, as mentioned above.