Can I offer a client a sliding scale even if the services are covered under the client’s health benefit plan? Can I offer a client a sliding scale rate after their insurance benefits end, to help them access therapy?

As stated in Standard 6.1: Fees, registrants “may not … charge more than the registrant’s usual fee for a service where a third party is paying for the service.” In other words, it would be unacceptable for a registrant to bill for services at more than their usual rate because the service is being paid for by an insurance company.

However, the standard also states it is acceptable to charge a lower sliding scale fee depending on ability to pay. There is a difference between charging someone a higher fee because they have insurance, and charging a lower fee based on ability to pay.

CRPO registrants may lower their actual fees in individual cases of financial hardship. This must be done on a case-by-case basis, and not through a general policy intended to hide a registrant’s true fee.

As well, Standard 5.5: Financial Records and the Financial Records Checklist both note that the financial record must indicate the reason or reasons why a fee may have been reduced or waived.

Please see the Jurisprudence e-Learning module for a related example.