Calculators
Private Pay vs Insurance Panel Calculator
Compare a therapist's income from private-pay clients and from insurance panels, allowing for reimbursement rates, billing costs and caseload.
- Runs in your browser
- Nothing uploaded
The tool
Enter your numbers below. Results update as you type, and nothing leaves your browser.
Everything you enter stays on your own machine. Nothing is sent to us or to anyone else, which you can confirm in your browser network tab.
What people use it for
- Deciding whether to join or leave panels
- Planning a private practice
- Setting caseload targets
- Consultation with practice coaches
About this tool
What the Private Pay vs Insurance Panel Calculator does
Joining insurance panels can fill a caseload but pays less per session and adds billing work and denials. Private pay earns more per session but may mean fewer clients. This calculator compares net income per week and per year under both models.
Formula
- Private = fee × sessions × weeks
- Insurance net = rate × sessions × (1 − billing) × (1 − denials) × weeks
Worked example
Using the starting values in the calculator above:
| Input | Value |
|---|---|
| Private-pay session fee | $160 |
| Private-pay sessions per week | 18 |
| Average insurance reimbursement | $105 |
| Insurance sessions per week | 26 |
| Billing cost (service or staff) | 7% |
| Revenue lost to denials and write-offs | 5% |
| Working weeks per year | 46 |
| Result | Value |
|---|---|
| Higher annual income | Private pay |
| Annual difference | $21,530 |
| Private-pay annual revenue | $132,480 |
| Insurance annual net revenue | $110,950 |
| Net per insurance session | $92.77 |
How to read the result
Count time as well as money: insurance sessions often need extra documentation and admin time per session.
Many therapists use a hybrid model, keeping a few panels while building private-pay demand.
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Questions
Questions about this tool
The things clients actually want to know — costs, timelines, ownership and what happens after launch.
Per session usually yes, but only if the caseload can be filled.
Rates vary by payer, region, licence and session code.
Yes; private-pay clients can often seek out-of-network reimbursement themselves.
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