If you see clients both online and in person, you have probably wondered whether the two should cost the same. Practitioners answer this differently and both answers can be right. What follows is how to work out which is right for your practice, along with the one situation that causes more trouble than the pricing decision itself.
Start with what actually changes
The session runs the same length. Your training is the same. So the real question is what each format costs you.
In-person work usually carries room cost, if you rent by the hour or the day. It carries travel, either yours or the time you block around it. It carries setting up and clearing between clients, and it carries equipment, supplies, laundry and cleaning.
Online work usually carries a platform subscription, and sometimes slightly longer admin, because links and reminders take a minute.
That difference is only meaningful if it is a cost you would avoid by not seeing the client in person. Hourly room hire is. A studio you lease for the year is not, because you pay for it whether anyone walks in or not.
The case for charging one price
Two prices invite a question you may not want asked: is the cheaper one worse? A lower online rate can read as a signal that video sessions are a lesser version of the work. If you believe the formats are clinically equivalent, one price says so more convincingly than any paragraph of explanation.
One price is also less to run. One number on your site, one on the invoice, nothing to justify.
The case for charging two
Costs that are real should be visible. A practitioner renting a treatment room by the hour is quietly subsidising in-person clients if everyone pays the same, and across a year that adds up to money worth keeping.
Two prices also hand the client a genuine choice, and a fair number will take the cheaper option without complaint.
A way to decide
Price the work, then adjust only for costs you actually incur per session.
Ask whether seeing this client in person costs you money you would not otherwise spend. Hourly room hire, parking, consumables and travel all qualify. An annual lease does not. If the answer is yes and the amount is material, two prices make sense. If the answer is no, charge one and spend the saved admin time on something better.
The part that causes arguments is the switch
A client books online and asks to come in. Another books in person, wakes up unwell, and asks for video. With two prices, you now have to decide which applies, in the moment, usually by text, often twenty minutes before the session.
Practices running both formats tend to meet this the hard way, improvising it once per client until somebody feels unfairly charged. Settle it in advance instead:
Which price applies when the client initiates the switch. How late a switch is allowed. What happens when you are the one who switches, because that should not cost the client anything. And whether a switch to the cheaper format after your cutoff still bills at the higher rate.
Write the answers down before you need them, not during the first awkward one.
Present it as two options, not a penalty
The wording matters more than the size of the gap.
"In-person sessions are $150, online sessions are $125" reads as a choice. "There is a $25 surcharge for in-person sessions" reads as a fine, for the same money.
Say what each option includes. If in person means a quiet room, equipment, or hands-on work that video cannot carry, name it. The difference then explains itself and nobody has to ask.
If you bill insurance, check before you set two rates
This is simpler for cash-pay practices. If any of your income arrives through claims, your payer contracts govern what you can charge, and many states have telehealth payment parity laws that require payers to reimburse telehealth at the same rate as the equivalent in-person service.
As of November 2025, Manatt's telehealth policy tracker recorded 23 states with full payment parity, five with parity subject to caveats, and 22 with none. Some apply only to mental health services, and some carry expiry dates.
Those laws govern what a payer must pay rather than what you may charge a private client. Even so, if claims are part of your income, confirm both your contracts and your own state's position before publishing two numbers.
Put it in writing
Your policy should state both prices, what each one includes, how a client requests a switch, the cutoff for switching, and which price applies after it. Keep it alongside your cancellation policy so a new client reads both at the same time, rather than discovering the second one after a disagreement.
Keeping two prices straight without thinking about it
The administrative cost of two prices is small but it is real, and it lands on the day you are busiest. Soap Notes lets you set up each service once, with its own price, and pick the right one when you book, so the correct amount lands on the invoice without you recalculating it between clients. Decide your policy once, write it down, and let the booking carry it.
