I’ve heard every reason in the book for why therapists avoid accepting credit cards: it’s too much of a hassle, the processing fees are expensive, or it’s not clear whether accepting credit cards complies with HIPAA.
I happen to be a huge fan of accepting credit cards in private practice, and I dish out all the reasons why in this article. I’ve happily been using Square since 2014, so In this article, I go over the benefits of using the Square app to accept credit cards in private practice.
(This isn’t an ad. I just like Square!)
The Downside of Not Accepting Credit Card Payments as a Therapist
Even though I’m a huge fan of accepting credit cards, I didn’t always have the luxury of doing so. When I was working in private practice as a pre-licensed intern, my supervisor had me accept exclusively cash or check for client payments.
The biggest downside? Misplaced checkbooks and forgotten stops to the bank often led to missed payments. I mean, who still walks around carrying a checkbook? I don’t! And personally, I’m lucky if I even have 20 bucks cash lying around in my wallet, let alone enough to cover a therapy session.
I spent a significant amount of time every month trying to track down missed payments, many of which I never recouped. Not only did I miss payments for sessions, but I ended up wasting a lot of time sending out invoices.
Why Accept Credit Card Payments for Therapists Using Square?
Once I got licensed and ran private practice on my own, I immediately started using Square to accept credit card payments in private practice.
Let me tell you: it was a total godsend! Here are a few reasons why it’s worth considering using the Square app to accept credit cards in private practice:
1. No More Missed Payments!
Can I get an amen??
Once I started using Square to accept payments for therapy, in addition to accepting cash and check, I now could accept debit, credit, and contactless payments as well. Unless clients completely forget their wallet at home, they nearly always are able to pay at the time of our session. I saw my income go up straight away, and I didn’t have to waste all that time tracking people down.
2. Invoice Options
Square also offers an option to invoice clients if we need to charge them outside of regular in-person sessions.
There are several scenarios where having the capacity to invoice clients comes in handy:
- Teletherapy appointments. Without a digital invoicing option, clients receiving online counseling would need to send a check via snail mail. And let’s face it: no one wants to deal with that.
- No-Shows/Late Cancellations. If you offer a cancellation policy that involves charging for missed appointments, you can send an invoice to your clients. There’s even an option to save a credit card on file to charge it if you prefer not to hunt your clients down. Just make sure you clearly spell all of that out in your informed consent.
- Forgotten Payment. I mentioned earlier that clients would need to completely forget their wallet to not have some form of payment available at the time of their appointment. However, it can happen. I saw this happen more often when I worked in San Francisco and clients left their wallet in their car parked several blocks away. The invoice solves this problem!
There’s also an option to set up automatic reminders if your client doesn’t pay their invoice in a reasonable amount of time.
Yep. Square is HIPAA-Secure! They offer a BAA (Business Associates Agreement) with everyone who uses their software.
I could spend a while talking all about HIPAA-security, but that’s not the focus of this post. So I’ll link to a few resources if you want to learn more:
HIPAA-Secure vs HIPAA-Compliant
As is the case with any HIPAA-secure software, it’s up to you to ensure you use it in a manner that’s HIPAA-compliant.
Swipe HSA and FSA Cards
This is HUGE. As mental health care providers, we qualify to charge our clients’ HSA and FSA accounts.
I have a whole article all about how to set up your Square reader to charge HSA and FSA cards:
Accept Health Savings Accounts in Private Practice Using Square
Positive Client Experience
Every little bit counts! I know personally I really dislike having to pay cash or check for any services. It’s a hassle to remember to bring my checkbook or to swing by the ATM to grab cash.
Being able to charge a client’s card or tap their Apple Pay helps streamline the transaction. That’s less time spent focusing on paying for therapy and more time focusing on the therapy itself.
What about Credit Card Processing Fees?
One complaint I hear from therapists is that the credit card processing fees are so high. When we use an app like Square (or any credit card processing company for that matter), they take a small percentage of the charge. This is how their business is profitable. Please be aware that depending on what state you live in, it may not be legal to pass the credit card fee onto your client! In these instances, you can’t charge a higher fee when a client uses their card vs cash. Make sure to check on the laws in your specific state to learn more.
However, if you do accept credit cards, assume 99 out of 100 times that clients will pay with their card. In other words, this is a nearly universal expense worth accounting for when you set your rate. In the same way that we account for the costs of rent, liability insurance, and other expenses when we set our rate, we can simply factor this fee in when we evaluate how much to charge our clients.
As of November 2019, Square updated its pricing as follows:
- For in-person transactions, Square charges you 2.6 percent plus 10 cents per transaction (previously, they charged 2.75 percent). Given the amount most therapists charge per session, this change ends up costing us less!
- For card-not-present payments, you can manually key in your client’s credit card info. This costs 3.5 percent plus 15 cents per transaction.
Click here to learn more about Square’s pricing.
You can watch me demonstrate how to use the Square app by watching the video embedded at the top of this post.
If you’re thinking about accepting credit cards in your practice, I hope you found this article helpful.
Ready to dive deeper into starting a private practice? I have a free guide for that! Check it out here to grab your free guide: Start a Private Practice in Counseling
Until next time, from one therapist to another: I wish you well!
Photo by Christiann Koepke on Unsplash
Hi, thanks for this article. One thing, it not illegal in all states to pass on the credit care processing fee to the client.
Dr. Marie Fang says
Thank you so much for letting me know! I will edit the post with this info.