Abundant Practice Podcast: Episode #730

How To Raise Fees Without Upsetting Referral Sources

Host: Allison Puryear
Guest: Kim Wheeler Poitvian
Date: February 7, 2026

Episode Overview

In this episode, Allison Puryear and guest Kim Wheeler Poitvian tackle a common source of anxiety for therapists in private practice: how to raise session fees without damaging relationships with referral sources or feeling ungrateful to colleagues who have helped grow their practice. The discussion offers practical strategies for fee increases, mindset shifts around charging, and ways to approach referral and client relationships with integrity.

Key Discussion Points & Insights

1. Normalizing Fee Increases

• Economic Context:
  Kim notes that it’s generally expected for prices to go up over time, given increases across all industries ([02:11]).

• Mindset Shift:
  Therapists first need to become comfortable with their own rates. Kim’s mantra:

  "Water is wet, the sky is blue, and this is what my rate is."
  — Kim Wheeler Poitvian ([02:36])

• Practice Saying Your Rate:
  Kim encourages therapists to practice stating their rates confidently—even to themselves in the mirror—so it becomes second nature and not something they waver on.

2. Communicating With Referral Sources

• Transparency is Key:
  Kim advises regularly checking in with referral sources, quarterly or semi-annually, to update them on changes, like dropping insurance panels or adjusting fee ranges ([03:25]).
• Outcome of Transparency:

  “As long as you’re transparent about that, they’ll be really clear about who they’re going to refer you to.”
  — Kim Wheeler Poitvian ([03:35])

3. Different Approaches to Raising Fees

• Flexible Implementation:
  Options include raising rates for all clients, just new clients, or having individualized discussions based on each client’s circumstances ([04:41]).
• Values-Based Decisions:
  Allison reminds listeners:

  “It really comes down to what your values are, how you run your practice, and really what aligns with you. There isn’t like one black and white way”
  — Allison Puryear ([05:19])

4. Client Affordability & Reducing Rates

• Selective Adjustments:
  If a loved, established client can’t afford the new rate, therapists can choose to keep their rate the same for that individual ([06:19]).
• Balancing Compassion and Business:

  “Do you want your therapist coming in just as stressed out and broken as you because they can’t pay their bills?”
  — Kim Wheeler Poitvian ([06:27])

5. Ethics & Financial Security

• Financial Insecurity Impacts Care:
  Allison references a study:

  “Therapists who were financially insecure were more likely to kind of like see their clients as dollar signs than the therapists who were charging more and felt more secure financially.”
  — Allison Puryear ([06:50])

6. Handling Negative Reactions from Referral Sources

• Letting Go of “Not For Everyone”:
  Kim shares that occasionally some referral sources may stop sending clients after a rate increase, but:

  “You aren’t for everyone and everyone isn’t for you...they want you. Or they figured out this is the best place for them to go and so we’ll make it work.”
  — Kim Wheeler Poitvian ([07:42])

• No Drama, Just Change:
  Allison remarks:

  “While I have stopped getting referrals from certain referral sources, probably because my fee went up, I’ve never had anybody talk trash to me about it. They just kind of quietly stop referring and maybe they judge you silently and that’s fine.”
  — Allison Puryear ([09:05])

7. Maintaining Integrity & Self-Care

• Stick to Your Values:
  If you know someone can’t pay your new rate and you have the bandwidth, ask “How much can you pay?” and negotiate from there ([08:30]).
• Letting Go of External Opinions:
  Kim and Allison both point out that you can’t control what others think or say and that’s okay ([09:25]).

Notable Quotes & Memorable Moments

• "Water is wet, the sky is blue, and this is what my rate is."
  — Kim Wheeler Poitvian ([02:36])

• “Do you want your therapist coming in just as stressed out and broken as you because they can’t pay their bills?”
  — Kim Wheeler Poitvian ([06:27])

• “Therapists who were financially insecure were more likely to kind of like see their clients as dollar signs than the therapists who were charging more and felt more secure financially.”
  — Allison Puryear ([06:50])

• “You aren’t for everyone and everyone isn’t for you…they want you. Or they figured out this is the best place for them to go and so we’ll make it work.”
  — Kim Wheeler Poitvian ([07:42])

• "I've never had anybody talk trash to me about it... they just kind of quietly stop referring and maybe they judge you silently and that’s fine."
  — Allison Puryear ([09:05])

Timestamps for Key Segments

• 02:11: Kim normalizes fee increases and introduces the “water is wet, the sky is blue” mindset.
• 03:25: Tips on staying transparent with referral sources.
• 04:41: Approaches to applying rate increases across client types.
• 06:27: The reality of therapist self-care and financial health.
• 06:50: Discussion of financial insecurity affecting therapist-client relationships.
• 07:42: Handling loss of referrals and focusing on your ideal clients.
• 09:05: Allison sharing her experience with losing referrals quietly, not dramatically.

Episode Takeaways

• Raising your rates is a necessary and normal part of running a sustainable private practice.
• Get comfortable and confident with your fees; practice stating your rate until it feels natural.
• Transparent, ongoing communication with referral sources helps preserve relationships and sets realistic expectations.
• It’s your business—you can make values-based exceptions for existing clients if you choose.
• Financial security for therapists benefits both practitioner and client, leading to better care.
• Loss of some referrals is to be expected; focus on those who respect your professional worth.
• Ultimately, you cannot control others' opinions—stick to your values and serve your ideal clients.

Resource:
A worksheet related to this episode is available via the show notes and social media—look for "Sheets."
For more support, check out abundancepracticebuilding.com or contact Allison’s team.