Fees for missed sessions
Introduction
On this page, we will address the issues related to missed appointments or last-minute cancellations by clients, as well as the question of obtaining financial compensation for these absences.
This text is primarily intended for (clinical) psychologists working as independent practitioners, although it may provide useful information for all psychologists.
Can I charge the client for missed sessions?
Clients frequently fail to show up for scheduled appointments or cancel at the last minute. Currently, there is no legislation that formally allows healthcare providers to demand compensation from clients in such cases. However, this does not mean that claiming compensation is legally prohibited. We encourage you to consider several ethical and legal guidelines. Your actions must also align with the dignity and integrity of the profession.
Compensation for the damage incurred, not a fee.
The amount you can claim for a missed session should be understood as compensation for the harm caused by the client's absence at the appointment, rather than a fee or remuneration.
The law also reminds that clinical psychologists, as healthcare professionals, can only charge fees for services provided (Article 35 of the Law of May 10, 2015, relating to the practice of healthcare professions).
Some basic rules
The client must be notified in advance.
"The psychologist has a duty of honesty and fairness regarding the financial implications of their professional activities. These implications must be agreed upon prior to the intervention" (Article 37 of the Code of Ethics).
This means that you can claim compensation for missed sessions, provided that you have formally informed the client in advance of the intervention.
You clearly state:
- How much in advance should the client notify you (e.g., 24 hours)?
- In what manner should the client notify you (e.g., by phone, via email)?
- What amount will you charge if the client notifies you too late or fails to notify you at all?
Furthermore, be aware that you can only claim compensation if the client is genuinely 'at fault,' and not in cases where, for example, force majeure is involved, such as illness or an accident.
The client must agree
A cancellation fee must always be part of a mutual agreement that does not harm either party. If you set an amount for the compensation due by the client, you should also specify an amount in case you miss a session yourself (Economic Law Code, XIV.50, 17°). Of course, you do not need to compensate the client if your session is canceled due to force majeure (e.g., illness or accident).
While the compensation amount does not have to be identical for both the client and the psychologist, a concrete amount must be set for both parties. If you fail to mention that a fee is applicable for sessions missed by you, or if you do not specify a concrete amount, the compensation you claim from your client in case of absence will generally be deemed illegitimate and null.
It may also be helpful (but not mandatory) to:
- Inform your client that in case of a missed session, you will not be able to provide them with a consultation certificate.
- Clarify that your client will not be able to claim the amount from their insurance, as the consultation did not take place. However, you will provide a receipt that specifies the nature of the payment received.
- Display the compensation rules on your website, in brochures, or in the waiting room.
Written or Oral Agreement?
You can formalize this agreement either orally or in writing.
Many psychologists refuse to establish written contracts to avoid disrupting the trust-based relationship with the client.
An oral agreement is generally sufficient but may lead to disputes if the case is brought before a judge. A written agreement, on the other hand, serves as proof that the client has agreed to the rules set by the psychologist.
It is up to you to decide whether to work with a cancellation fee and whether to formalize this agreement in writing. In this case, we suggest weighing the following factors:
- Your working framework
- The situation and characteristics of your client
- The psychologist-client relationship
- Potential loss of income due to the client’s absence
What amount can you charge?
The amount you claim must be reasonable and proportional to the financial damage you have suffered due to the client’s failure to attend the appointment.
If this condition is not met, the amount requested will be considered abusive and void (Economic Law Code, XIV.50, 24°). If the matter is brought before the court, the judge may reduce the amount demanded if it is deemed excessive.
Is it acceptable to charge the full price of a consultation? Again, there is no specific legislation on this matter, and ‘common sense’ remains the best course of action.
Obtaining the Compensation
You have followed the conditions outlined above, but your client still refuses to pay the compensation? In this case, you may consider bringing the dispute before a justice of the peace.
Before initiating this process, you must formally notify your client via a registered letter. Then, you will need to provide proof that:
- your client missed the appointment,
- a prior agreement was made in writing, specifying that compensation would be due under certain conditions,
- in this case, the required conditions have been met.
However, be aware that a legal procedure involves costs, and you may not always be able to recover them fully. Legal action should remain a last resort, and only in cases where absenteeism has caused significant financial losses. Therefore, it is inappropriate to pursue such a process for just one missed
Precautionary Measures
Respecting an agreement is a sign of respect in itself. However, it can always happen that a client forgets their appointment, without bad faith being involved. You can take steps to prevent missed appointments on your side.
Appointments should be scheduled clearly. You can also use automatic reminders via email or SMS to your client 48 hours before the appointment time. These tips can help reduce absenteeism.
Legal Sources
- Code de droit économique, Livre XIV "Pratiques du marché et protection du consommateur relatives aux personnes exerçant une profession libérale"
- Code de déontologie du psychologue
- Avis du Cabinet d’Avocats Callens
Literature
- Federatie Vrije Beroepen (2013). De cliënt bleef weg op de afspraak: Kunnen wij nu een schadevergoeding eisen? De Vrije Beroeper, september-oktober-november 2013, p. 10
- Deel I, hoofdstuk III ‘De gezondheidszorgvoorzieningen’ en deel IV, hoofdstuk III ‘Het recht op een honorarium’ in Vansweevelt D. & Dewallens F. (eds) (2014). Handboek Gezondheidsrecht. Volume I. Zorgverleners: statuut en aansprakelijkheid. Intersentia: Antwerpen-Cambridge.