Episode #730: How To Raise Fees Without Upsetting Referral Sources

Summary

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Abundant Practice Podcast: Episode #730

How To Raise Fees Without Upsetting Referral Sources

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

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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.

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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]).

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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])

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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.

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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.

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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.

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Transcript

[A]

Foreign.

[B]

Welcome to Ask Abundance. Y' all ask the questions about having a fun and thriving practice. We answer them. We have a worksheet for you today so you can bring this answer into your life. If you want support in your practice, we have you covered with on demand or one on one support. Links for the worksheet and support are in the show. Notes can't get enough Ask Abundance. Check out our YouTube channel for the entire library. Welcome back to Ask Abundance. Today I'm joined by Kim Wheeler, Poitvian. Kim's going to be doing one on ones with Abundance, just like she has for years and years. So if you're interested, go ahead and hit the link in the bio. Here's today's question. I've been in private practice for a few years and I'm consistently full, but my fees haven't really changed since I started. I know I need to raise them to keep this sustainable, but I'm scared that doing so will upset the referral sources I've helped that have helped get me here or make them stop sending people my way altogether. I don't want to burn bridges or look ungrateful, especially with colleagues and agencies I genuinely respect. How do I raise my fees in a way that protects those relationships and doesn't blow up my referral pipeline. So by Kim's face, I know she has the answers too. Before we get into it, I would love to thank our sponsor, TherapyNotes. I've talked about Therapy Notes for years and know their features by heart, but here's what truly sets them apart. First, they genuinely care about your experience. It's not just about troubleshooting. They actively implement user suggested features like Therapy Search, secure Messaging and their AI notes feature. Therapy fuel. Everyone at TherapyNotes believes in the product and they want you to love it too. Plus, they're independently owned, which means no venture capital and no pressure to prioritize investors over their customers. This independence allows them to keep prices fair, focus on innovation, and prioritize customer experience. With over 100,000 therapists already on board, they've proven that you don't have to compromise success for quality. If you're ready to see for yourself, try Therapy notes free for two months with the code [e-mail] all right Kim, let's get into it.

[A]

Okay, heavy question. So I would say the first thing is that most, not all people are going to understand that rates are going to go up because price everywhere has gone up. So that's the first thing is that that you have to yourself that you need to raise your rate and get comfortable with it. And the one thing that I talk to each person that meet with on the call is to get comfortable with what your rate is. Even if you're like looking in the mirror and you're saying what it is, that you know that that's what your rate is. And to say it and that way that you're not guessing at what it is, that you just know exactly that this what it is. And my favorite thing is water is wet, the sky is blue, and this is what my rate is. So that you know that this is what the truth is and that you can start initially with new clients with this is what your rate is and get comfortable with charging them that. That way that once you start having these referrals that are coming in from other places, that they're also going to see what your referral, what your actual rates are. A lot of times they're going to expect that the rate is going to go up. Or if you are meeting in regularly with these referral sources, I always recommend to check in with them on a regular basis, whether it's quarterly or every six months or so. And you're touching bases them anyway. So you're saying, hey, I just want to give you an FYI that I'm moving off of this particular insurance panel, or just to let you know, this is what my range still is. And as long as you're transparent about that, they'll be really clear about who they're going to refer you to. It's really more so us as a clinician and as a business owner that gets really caught up in, is anyone going to refer to me? Some people are and some people aren't. You may price some people out. And other people are going to say, okay, well, maybe this particular person can't afford you, but I know someone else that will be able to afford you.

[B]

Yeah, yeah. And this person doesn't mention insurance, so that always makes me think they might be private pay already.

[A]

Yeah.

[B]

And if you're already private pay, a fee raise is less unexpected. Right. I think with insurance, we end up being like, oh, I'll take what I can get. Kind of a mentality around it. Yeah. And I think too, this smacks of the fear that so many of us feel when we're about to raise our rates of like, everybody's going to hate me for this.

[A]

Yeah, absolutely. That you're totally terrified that they're going to say, oh my goodness, I can't work with you anymore, or there's a bigger Thing of why do you think you deserve that increase? Like, have I done the work for it? You know, how everything is and the reality that that's what your rate is and that you don't necessarily always have to. Like, each person has their different thing about how they do with their own practice. Some people increase everyone's rate. Everyone they can say, okay, starting on January 1st or March 1st, everyone's rate is going up to this. Some people just do it for new clients, or some people have a conversation with each of their individual clients to have that, you know, to see whether or not they can afford it. So 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 of running your business and so something doesn't speak to you and you don't feel comfortable jumping a person up and you're like, okay, well they have a hard time even paying my current rate because it declines or whatever. Then maybe that particular client needs to have a conversation with you and you all discuss that. And that might not be a person who is a candidate for that need increase, but maybe your new people are. Maybe someone else is.

[B]

Yeah, I mean, that's the beauty. It's your business. You can do what you want. If you love working with a client, you know, and I think. Wait, before I say you know, because we feel like we know what our clients can afford all the time. Let's say you work with a client you love working with, you tell them your fee increase, they let you know it's not possible for them.

[A]

Yeah.

[B]

At that point you can keep them exactly where they're at.

[A]

Absolutely. Absolutely. I think there's this fear that we get into this because we don't do it for the money, but it also really real about the fact that do you want your therapist coming in just as stressed out and broken as you because they can't pay their bills? Because financial insecurity is a huge factor in mental health issues. And so if we can't really take care of ourselves, how are we actually going to take care of the people that we need?

[B]

Yeah, I saw an article and I wish I'd saved it, but I saw an article that showed that 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. Which is funny because that's what gets hurled at private pay therapists all the time is like, you're only in it for the money or like, you just see your clients as dollar signs when.

[A]

Yeah, yeah.

[B]

It's less likely to happen when you're taking care of yourself financially 100%. Yeah, yeah. And I think that worst case scenario, let's say one of your referral sources is like, you know, Kim, I really appreciated you and I liked referring to you before, but you raising your rates so much, I don't know, I don't really feel so comfortable referring to you anymore.

[A]

I always have the saying that you aren't for everyone and everyone isn't for you, and that there are some times that I really worried about that, especially when I first opened my practice, that I was pricing people out. But I still get a call, maybe sporadically from that particular person or that particular agency because this is what my specialty is. This is what my niche is. And they've gone everywhere else. And then they're like, you know what? We circle back and this. They want you. Or they figured out that this is the best place for them to go and so we'll make it work. And then from there you again have a conversation about rate. You have a conversation about, okay, could I afford to have this person in a reduced rate? If that's fits within that. If you can do that within your budget and you get to kind of a point where I now, like, if I know that I'm going to take this person in, that I know that they can't afford my actual rate, I just ask them, how much can you pay? Because that way I'm comfortable. Now they know what my rate is, I know I charge. Everyone else will be, well, how much can you afford? And that way I don't have this thing of like, I need this person in here and I need to calculate it. It's just like, well, how much can you afford? And that way that we can actually do the work and that they can be financially comfortable and we can just do what we need to do.

[B]

Yeah, yeah. And I have to say, like, 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.

[A]

Right.

[B]

Like, they just kind of quietly stop referring and maybe they judge you silently and that's fine. But yeah, yeah, absolutely.

[A]

Absolutely. And you really can't control that. Right. And that, I mean, and if we're kind of looking at the. Whatever we're going to see on the content that's created about, I believe therapists should be charging this amount or whatever the hot takes are. That's fine. Just like they could probably cringe about whatever it is that we're saying too, and that they don't agree with it. And that's fine.

[B]

Yeah. Yeah. Amazing. Awesome. Thank you, Kim y'.

[A]

All.

[B]

We're going to have a worksheet that relates to this conversation that you can access on social by using the Word Sheets, and it'll also be in the Show Notes for you to click. If you have questions for Ask Allison, get in touch. Thanks so much. If you're ready for a much easier practice, TherapyNotes is the way to go. Go to therapynotes.com and use the promo code abundant for two months free. I hope that helped. Please get in touch with any of your questions for Ask Abundance. If you're listening, you probably need some support building your practice. If you're a super newbie, grab our free checklist using the link in the Show Notes. I'd love for you to follow rate and review, but I really want you to share this episode with a therapist friend. Let's help all our colleagues build what they want.