How to Get Paid Quickly and Easily for Private Therapy Services

FYI: This post was inspired by a discussion in The Private Speech Therapy Network LinkedIn Group. Participants were responding to the question:

For those of you that are private pay only, do you ask your clients to pay by cash, check or credit card?

When you’ve got private pay clients you want to:

  • Keep them happy 
  • Get paid quickly and easily (which will keep YOU happy) 

Traditionally, people with “cash only” practices get paid in cash or by check as “fee for service.” While there are many clinicians still doing doing, there are a whole host of new ways to collect payments from your private clients.

Let’s discuss various methods of payment, as well as the pro’s and con’s.

1. Cash

How to Get Started:

  1. Let your clients know that you accept cash only 
  2. Be firm about receiving payment on the date of service 


  • People are used to paying cash for services 
  • It’s cut and dry (I provide a service; you pay me for that service) 
  • You’re payed instantly. No need to hunt people down. Remember: “A bird in the hand is worth two in the bush.” 


  • Cash can be hard to keep track of 
  • Many people aren’t using cash as much these days (credit cards are becoming the most common way to pay for goods and services) 

Why I Use Cash
“I only accept cash!  I had problems with checks bouncing in the past and then trying to collect payment from clients, even with their signature on 1 of my forms from the start of therapy.  I don’t accept credit cards/paypal, etc.–too expensive!”
Francine Pickus
Babylon NY


2. Checks

How to Get Started:

  1. Get a business checking account to deposit your checks
  2. Tell people you accept checks
  3. If you’re interested, sign up for Freshbooks to send very nice looking invoices and Outright to track your income/expenses/taxes


  • People are used to paying for services via check
  • It’s easier for you (and them) to keep track of the payments


  • “Oh, I’ll bring you the check next time”
  • Sometimes checks bounce
  • You have to go to the bank (unless your bank allows for deposits via an app)

No fee; unless you have a monthly checking account fee from your bank

My Experience with Checks:
Judith S. Harper MA CCC SLP • All of my clients pay by check or cash. I do have an account set up for PayPal, but none of my clients have asked to pay by credit card.


3. PayPal

How to Get Started

  1. Sign up for a Business Account
  2. Set up and send an invoice
  3. Add a PayPal button to your website (optional)
  4. You’re ready to collect payments!


  • Many people have PayPal accounts (BUT you don’t need a PayPal account to use it)
  • PayPal encrypts financial data and is very safe to use
  • People can pay for services directly on your website
  • Free, built in invoicing 


  • Some people are still weary of PayPal due to early customer service headaches
  • PayPal is fairly simple to use – but can be confusing for less-computer savvy people
  • The money shows up in your PayPal account immediately but it takes about 2 business days to transfer to your bank
  • You’ll need to connect your account to your bank (some people are wary of this –> it is very safe though)


  • 2.9% + $0.30 per transaction
  • PayPal fees are tax deductible

Why I Use PayPal
Lisa Scott, owner, Accentuate • I have used Paypal for a couple of years now and find it easy and convenient to use. Since I also work with foreign clients on accent reduction, their automatic money conversion is a great feature for me, and the invoicing is very easy to use. I also have a Paypal debit card and payments are credited to my account and available for use immediately. The only delays I’ve ever experienced were when a couple of clients in other countries had a delay in getting their credit card approved for use through Paypal.


4. Square

How to Get Started

  1. Sign up for a Square account online
  2. They’ll mail you a free card reader OR  Buy one at The Apple Store, Target, Best Buy or Walmart for $10 (but get a $10 redemption code so it’s still FREE)
  3. Download the App
  4. Enter your business and financial information
  5. You’re ready to collect payments!


  • It’s free to join. No monthly or membership fees
  • On the spot payments – great for clients AND you (i.e. no invoicing!)
  • Next day direct deposit into your bank account
  • You and your client get a receipt for easy tracking


  • You need to have a smart phone or tablet (ex. iPhone, iPad, Droid)
  • It’s a new technology, some people may be wary

Fees: 2.75% for all credit cards

Why I Use Square: 
Melinda B. Croft, Accent On Speech, Corvallis, Oregon

“I use Square for credit card payments, it is a little reader that attaches to your iPad, iPhone, or Android smartphone. You swipe, charge, and they sign on the screen with their finger! Then a receipt gets sent to their phone or email. No membership or sign up fees, just 2.75% rate is charged for each transaction.

5. Quickbooks

How to Get Started

  1. Purchase and setup QuickBooks (there is an option for non-Quickbooks users too)
  2. Sign up for a Merchant Account


  • Integrated with QuickBooks software; seamless for QuickBooks users
  • Easy invoicing
  • There is a free external card swipe reader (similar to Square)
  • Easily store credit card info (pre-authorized by your client) for easy re-billing
  • Can set up recurring charges


  • Best for those already using QuickBooks
  • $20 monthly fee (waived for 1st two months)


  • $19.99/month (after two month free trial)
  • 1.6% for cards swiped
  • 2.47% for key entered

Why I Use Quickbooks
Jordan Sadler, MS, CCC-SLP • I use the Merchant Services offered through QuickBooks. The fees are comparable to Square but I can do it from anywhere – so if I’m at home at night I can look at my staff’s attendance form online and go ahead and process all the credit cards for the day. I also love it because I can do it from within my invoices – click Receive Payment and the credit card option and then it uses the stored credit card info in the system. I just add the CVV and it’s processed *and* immediately applied to the invoice so that I can email that out marked Paid. It’s worth fees for me to have this all happen so smoothly and the money hits my bank in a day or two.

I was hugely tempted by Square, I’ve seen it in use and it’s a terrific system, but we see so many clients in their schools (without their parents) where I don’t have physical access to their credit cards and I wouldn’t want my staff having to run cards. It would only work in my office if I were present and so were the parent.

On Accepting Cash vs. Credit Cards:
Kayle Shulenberger • I found accepting credit cards helps with cash flow. So many don’t write checks anymore..I sure don’t!

Jordan Sadler, MS, CCC-SLP • Yes – huge cash flow benefit! It’s made a big difference. Now that I accept credit cards, about 80% of my clients are paying that way.

“But I Don’t Want to Pay The Fees!”
Yes, many of the electronic formats have additional fees – but they are minimal compared to dealing with bounced checks or non-payment. Also, electronic formats are automatic! No need to go to the bank. Everyone is always complaining about not having enough time – electronic methods can help that.

You may find that the convenience is worth it.

Oh, and don’t forget – the fees are tax deductible!

Jena’s Perfect Solution
Freshbooks + Check + Outright
“I personally have found that creating invoices in Freshbooks, then automatically sending the bill to patients via PDF or snail mail works best for me. The clients then send me a check or bring it to their next session (there is also a PayPal option). They keep the invoices for their records and I keep the invoices for my records. Freshbooks tallies everything up and keeps track of whether or not people have paid. It also sends reminders for late payments and or late fees.

My account is integrated with Outright, so that I know exactly how much income, expenses and taxes I need to pay each year. This system works smoothly for me.”
– Jena H. Casbon, MS CCC-SLP

Final Take-Aways:

#1: Offer Payment Options
Your goal is to get paid. Being flexible about the forms of payment you accept only help that. Think about it: when you go to the grocery store, the beauty salon, a restaurant, etc. you pay via different formats according to your circumstances that day.

#2: Experiment to Find What Works for You (and them!)
I’ve presented you with some options that you may or may not have heard of. Research them. Contact the companies. Try it out! See what works for you and your patients.

Don’t feel pressured to use or try all of the. Ask your patients what they are interested in and if they would like to pay via another method. You may be surprised at their answer!

#3: Do Whatever It Takes to Get Paid
Enough said.

Jena H. Casbon, MS CCC-SLP is a speech-language pathologist and private practice consultant. She started her own speech therapy private practice in 2006. She is the founder of The Independent Clinician and author of The Guide to Private Patients and The Guide to Creating a Web Presence for Your Private Practice. Since 2008, she has helped thousands of clinicians get the flexibility, income and freedom they desire from starting their own private speech therapy, occupational therapy and physical therapy practices.

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