How to Price and Launch a Cash-Pay Program

Move to cash-pay in steps. Keep the insurance work that pays the bills today, build the cash-pay program next to it as its own business, and price it backward from the income you want. A practice owner I spoke with wanted to leave insurance work behind, but you can't turn the water off on day one. It has to be a shift.

Why keep insurance work while I build?

Because the new program takes time to fill, and you still have bills to pay today. The insurance work keeps the lights on while the cash-pay side grows.

Keep the two clearly apart, though. As I understand it, once you take insurance, you can't set your own rate for that service. The allowed amount is what you can take. And if your cash-pay offer looks like the same service you bill to insurance, clients who hear you take insurance will want to pay with insurance. So I think you need two businesses: the insurance practice, and a separate program with its own offer and its own buyers. Check the billing rules for your field with someone who knows them well.

How do I set the price?

Work backward from the income goal. Here is the math I walked through with one owner. Say the goal is $500,000 a year at $400 an hour. Give yourself about a month off, so roughly 48 working weeks. That takes about 26 hours of client work a week.

Or price it as a monthly program. At $1,000 a month per client, $500,000 a year means about 42 active clients. Because some clients will always be leaving and new ones joining, you need a steady stream coming in to hold 42.

The monthly program also needs something between sessions, like app check-ins, digital engagement or a place where clients can reach you. You will need to spend some time monitoring that, so the client feels looked after all month.

How do I sell it to clients?

Sell it as an investment in themselves, not as treatment. The right client is not coming to fix something. They are coming to get better, to be more productive and to improve themselves. For a busy executive, $1,000 a month is easy to justify if they believe they get far more than that back in value.

Be specific about who you want. For one performance-style offer, I suggested people at vice president level and above, people in high-stress jobs, people who were recently promoted, or people at companies that are not doing well. Under stress is when people tend to look for help.

How should the offer be structured?

Get a real commitment up front, then keep people connected. One structure I like is a program of several months, with a commitment of five or six thousand dollars up front, and then a small monthly subscription to your digital tools after it ends. Follow-up sessions are booked at your hourly rate. Some people will never buy the big program, and a low-cost subscription gives them a way in.

Why are more people paying cash now?

Deductibles. When people carry deductibles of nine or ten thousand dollars a year, insurance starts to work like a catastrophic plan. They pull out a credit card at almost every visit anyway. I live this myself as a business owner who buys my own plan, and it changes how people think about paying for their health directly.

Where to start

Write down your income goal, your hourly or monthly price and the weeks you want to work. Do the division to get the clients or hours you need. Then design one up-front program and one small subscription, and test them with a few clients while the insurance work carries the practice.