Income-Based Sliding Scale Fee Structure
An income-based sliding scale for therapy is a fee structure in which clients pay for mental health services based on their financial capacity, with fees adjusted according to income level and ability to pay. Instead of charging all clients a single fixed rate, psychologists and other therapists who utilize sliding scales offer services at varying price points, making therapy more financially accessible to individuals across different socioeconomic backgrounds.
This approach offers several key benefits. First, it increases accessibility to mental health care for populations who might otherwise be unable to afford services, helping to address the socioeconomic disparities in mental health treatment access. Second, sliding scales allow therapists to maintain sustainable practices while serving diverse communities, creating a more equitable healthcare environment. Research also suggests that when clients pay amounts that feel fair and manageable for their financial situation, they may experience greater commitment to the therapeutic process and better treatment outcomes. Rainy Day Psychology currently has the capacity to support a few clients on a sliding scale, with fees determined based on household size and household income relative to the Federal Poverty Level guidelines, making quality mental health care accessible to those experiencing financial constraints.
Please review the information below, and if you qualify for an income-based slide, complete the the sliding scale application which can be requested through the client portal.
Apple Health Eligibility
Individuals with incomes below these amounts may qualify for free health coverage through Washington Apple Health (Medicaid):
| Household Size | Monthly Income | Annual Income |
|---|---|---|
| 1 Person | $1,800 | $21,600 |
| 2 Person | $2,433 | $29,196 |
| 3 Person | $3,065 | $36,780 |
| 4 Person | $3,697 | $44,364 |
| 5 Person | $4,330 | $51,960 |
| 6 Person | $4,962 | $59,544 |
| 7 Person | $5,595 | $67,140 |
Annual Income Brackets by Household Size (Above Apple Health Eligibility)
| Tier | Discount | 1 Person | 2 Person | 3 Person | 4 Person | 5 Person | 6 Person | 7 Person |
|---|---|---|---|---|---|---|---|---|
| Tier 1 | 75% | $21,601 – $31,300 | $29,197 – $42,300 | $36,781 – $53,300 | $44,365 – $64,300 | $51,961 – $75,300 | $59,545 – $86,300 | $67,141 – $97,300 |
| Tier 2 | 50% | $31,301 – $46,950 | $42,301 – $63,450 | $53,301 – $79,950 | $64,301 – $96,450 | $75,301 – $112,950 | $86,301 – $129,450 | $97,301 – $145,950 |
| Tier 3 | 25% | $46,951 – $78,250 | $63,451 – $105,750 | $79,951 – $133,250 | $96,451 – $160,750 | $112,951 – $188,250 | $129,451 – $215,750 | $145,951 – $243,250 |
| Tier 4 | 0% | Above $78,250 | Above $105,750 | Above $133,250 | Above $160,750 | Above $188,250 | Above $215,750 | Above $243,250 |
Service Fees by Income Tier
Consultation
- 15 minutes
- Let’s meet to see if this will be a good fit.
- Fee: $0 (all tiers)
Diagnostic Evaluation
- 50 minutes
- Initial visit to establish care and set treatment goals.
| Tier | Fee |
|---|---|
| Tier 1 | $75 |
| Tier 2 | $150 |
| Tier 3 | $225 |
| Tier 4 | $300 |
Individual Psychotherapy (60 minutes)
- A longer follow-up appointment that lasts at least 53 minutes.
| Tier | Fee |
|---|---|
| Tier 1 | $75 |
| Tier 2 | $150 |
| Tier 3 | $225 |
| Tier 4 | $300 |
Individual Psychotherapy (45 minutes)
- A follow-up appointment that lasts at least 38 minutes.
| Tier | Fee |
|---|---|
| Tier 1 | $55 |
| Tier 2 | $115 |
| Tier 3 | $170 |
| Tier 4 | $225 |
Individual Psychotherapy (30 minutes)
- A brief follow-up appointment that lasts at least 16 minutes.
| Tier | Fee |
|---|---|
| Tier 1 | $37.50 |
| Tier 2 | $75 |
| Tier 3 | $112.50 |
| Tier 4 | $150 |
Crisis Psychotherapy (60 minutes)
- 30 or more minutes of crisis support, 60 minute minimum.
| Tier | Fee |
|---|---|
| Tier 1 | $75 |
| Tier 2 | $150 |
| Tier 3 | $225 |
| Tier 4 | $300 |
Crisis Psychotherapy Additional Time (30 minutes)
- Each additional 30 minutes of crisis support.
| Tier | Fee |
|---|---|
| Tier 1 | $25 |
| Tier 2 | $50 |
| Tier 3 | $75 |
| Tier 4 | $100 |
Verification Process
To qualify for the sliding scale clients must complete a short sliding scale application and provide documentation of their annual household income, such as:
- Most recent tax return
- Pay stubs from the last 2 months
- Unemployment or disability benefits statement
- Social Security statement
Policy Notes
- Income verification is required annually to maintain sliding scale rates
- The sliding scale is subject to periodic review and adjustment
- Clients experiencing temporary financial hardship may request a temporary fee adjustment
This fee structure aims to improve access to mental health services while maintaining practice sustainability, following evidence-based approaches to sliding fee scales. Income brackets are based on the 2025 Federal Poverty Level guidelines and utilize a graduated discount structure to maximize both accessibility and financial viability.