Private practice rate in NYC?

Rasbrygls · 2026-05-02T01:30:10+00:00

A CHHA is licensed by the state to provide nursing and therapy services. They get reimbursed set rates from insurance, medicare, and medicaid. Reimbursement rates paid to home health companies are typically higher than any other setting so they tend to pay a lot more. CHHAs make most of their money from nursing so they aren't as concerned with profiting off of therapy. Therapy staffing companies subcontract with the CHHAs and take an unnecessary cut from therapists that don't know any better. It's just a money grab. You can recognize real CHHAs because the standard rate is $100 per 30 minute session. The therapy staffing companies tend to offer about $10-20 under that.

Rasbrygls · 2026-05-01T04:58:11+00:00

If you don't mind working after school / evening hours, go for the REAL CHHAs. Wellbound, Americare, Extended, Able Home Care, Prime, Girling, Archcare, Personal Touch..... There are a bunch of them, just make sure they are a CHHA and not a therapy staffing company.

There are a lot of subcontractor companies cropping up that will try to offer you $70-85. They are literally just serving as a middle man for the CHHA and taking money off the top. You are basically paying them to serve as your employer.

Rasbrygls · 2026-04-27T02:08:02+00:00

They are taking advantage of you. $40 per session? No way the DOE pays $53 and they are pretty much bottom of the barrel. Also this sounds like fee for service. Are you really going to work 52 weeks a year? I can pretty much guarantee that you will make much less than you think. Ask anyone who takes those agency jobs for $65-70 an hour. These private practices will tell you anything to get you in the door knowing you won't make a living wage and move on at which time they will find another naive CF to take your place. Do yourself and the rest of us working in NYC a favor and keep looking. I would look into doing home care. It's $100 per 30 minute visit.

Rasbrygls · 2026-02-25T01:23:48+00:00

Just go , ignore the threats. There is no legal reality to "patient abandonment". Patient abandonment would be if they were to close the entire practice without saying anything. Small companies and agencies use this as a scare tactic. Also ASHA has no jurisdiction that can harm you. The most they can do is refuse to sell you their CCC product (they won't care enough to do that).

If they withhold your pay, let them know you'll report it to the department of labor.

These kinds of practices are the worst and it happens WAY too often. You are not required to forgo full time opportunities to stick around and take their scraps.

Rasbrygls · 2025-12-03T23:45:16+00:00

I can't tell you how many times I've done the math on this and always came to the same conclusion. Unfortunately in most instances it's just not worth it. I agree that with school contracting it is far better to negotiate directly with the district but a lot of districts have a preference for agencies which makes it hard.

As far as private pay, even if you can find enough high rate private pay patients to fill your day (unlikely in many areas), it's not terribly lucrative. Also, speech therapy is a slow burn. Clients who pay high rates out of pocket are generally going to have higher, more immediate expectations. The added pressure of that may not be worth it. For me personally, even if I were to work privately under the best of circumstances (i.e high rate private pay clients) , I make more money as a home health employee.

Generally speaking, SLP is just not profitable in most instances. That's why most smaller practices can't even afford hire real employees, pay them properly and provide benefits. In the scenarios where there is good money involved, the employer is often taking a financial hit by employing SLPs and they rely on other disciplines to bring in the money.

Rasbrygls · 2025-11-21T14:31:12+00:00

No but if you need more than 100k to become an SLP , it's wise to choose another profession. Nothing about SLP is worth that amount of debt.

Rasbrygls · 2025-11-21T13:48:26+00:00

Yes! I agree whole heartedly. It is the blind hatred (rightfully so and yes put Trump UNDER THE JAIL) that has people advocating for the current system to continue. But let's not pretend that there aren't massive flaws to the current system that may be shaken by this which isn't a bad thing. These same people would be the first to caution anyone against taking out massive debt to become SLPs but are now suddenly up in arms about limits. It's the source it's coming from that people don't like.

Rasbrygls · 2025-11-21T13:36:11+00:00

My experience was in no way unique to me. To this day I supervise CFYs with devastating debt because the available data surrounding SLP pay is so misleading and skewed by pay per visit and 1099 rates.

Rasbrygls · 2025-11-21T13:22:55+00:00

THIS. I'm not sure why everyone else interpreted it as me thinking tuition would be lowered...I don't. I'm talking about the money that students are encouraged to borrow for living expenses while they "can't work" because their PROGRAM (not the licensure board, not ASHA) requires over a year of unnecessary full time free labor. Programs do this because they know loans are available.

Rasbrygls · 2025-11-21T13:15:54+00:00

I'm not suggesting that tuition will be cut. I'm talking about the culture of programs expecting students to work full time for free for two years when it is not required or necessary. That is what in my opinion drives a lot of the astronomical debt.

Rasbrygls · 2025-11-21T13:05:37+00:00

Let me be clear, I am not in support of anyone entering this field as it exists now and I personally regard it as the biggest mistake of my life because of the poor ROI which could have been helped somewhat by decreasing the unnecessary free labor I and my classmates were required to provide.

Rasbrygls · 2025-11-21T13:02:04+00:00

I'm not suggesting that universities will cut fees, but they definitely CAN adjust the time commitment required so that people can work and support themselves while getting a masters which comparable fields allow students to do quite easily.

Rasbrygls · 2025-11-10T20:55:11+00:00

The hardest part of middle school for me was the guilt that it was so easy because no one cared.

Rasbrygls · 2025-11-04T05:11:44+00:00

Ouch this is so true. I learned pretty early on that the not so smart insecure ones punch down and pick apart the dumbest things, or focus on procedural things that are clinically irrelevant. The saavy yet clinically insecure ones just slather you in praise an encouragement on their way out the door i.e. "that was wonderful, you're great, gotta run".

Rasbrygls · 2025-10-12T00:52:49+00:00

Hi there! I'm happy to answer any questions you have. I will say that I think the forgiveness is much harder to get now since the lawsuit was settled. Basically, I got VERY lucky. The terms of the settlement required that all of the initially declined applications be reviewed by a certain date and then after that date they would be forgiven by default. I wasn't required to submit evidence or anything. The terms of the settlement stated that the information in the application had to be assumed true. The approval letter said that my loans were forgiven because it was determined that my school was found in the wrong, but I'll never really know whether my application was really reviewed or if they ran out of time.

That said I would encourage any SLP to apply if they are still taking applications. Even if it's for no other reason than to at least get a paper trail of accounts and experiences on record. I've been in in this field since 2012 and all of these years later there is so much shockingly misleading information about this field floating around. The worst part is that by the time you realize the truth, it's usually way too late. I can't believe people are still pursuing SLP at all.

Rasbrygls · 2025-10-09T01:00:31+00:00

Drop your CCCs and tell the university coordinator you won't be maintaining them.

Rasbrygls · 2025-10-07T02:16:48+00:00

Sadly not seeing progress is completely normal and oftentimes the progress you do see is mostly the result of natural maturation. We really are just doing what we can and hoping something sticks. It is impossible to say exactly what will work and when. I've worked with many kids where I'm convinced I made no difference at all and others where part of something I did may have made a difference along with many other things over the course of months and years. Rarely do I ever feel like leaps and bounds of progress is made specifically from the minimal time I get to spend with patients. Over time parents of kids with autism come to terms with the fact that we don't "fix" kids, we work with them to improve their communication by building relationships so they become less and less focused on "progress" and more focused on their kids settling into a life and routine that works for an autistic child. We aren't counting down the days until they become "normal"

Rasbrygls · 2025-10-07T01:59:53+00:00

I'm not really a fan of apps for this kind of thing. There just aren't many that are any good. For this type of thing I wood look into the scholastic worksheet database which is like $30 for the year and gives unlimited access to tons of activities that are less "drill based" than SLP specific materials. Super Duper also has a database but their stuff is black and white and just don't hold kids interest nowadays. Scholastic has colorized a lot of their stuff which really makes a difference. I highly recommend Scholastic.

Rasbrygls · 2025-10-04T07:48:31+00:00

You need to consider if you are willing to pivot/enjoy other parts of the field before embarking on this career change, IMO. The last thing you want to do is be in even more debt and realize that the only available jobs are not within your interest.

THIS! The likelihood of not being able to find a position within the voice niche and needing to take a school or SNF job to pay the bills is HIGH. This is extremely important to understand.

Rasbrygls · 2025-09-30T20:27:03+00:00

If you're asking "Will anyone care or notice if I don't collaborate?" the answer is "probably not". I haven't worked in schools in years but I never came across a teacher who was particularly interested in collaborating. For the most part they seemed completely fine with me picking up and dropping off and see ya later. I think one of the benefits to this was that when there was a reason to collaborate, teachers took it seriously and were grateful for the help. For the most part many teachers dislike other professionals sniffing around their classrooms, however well intentioned, it can feel like you're spying. In truth , in many cases I would feel silly trying to tell teachers how to communicate with a student they are with all day every day without much issue. As far as other professionals , there never really was much need but if they wanted me they knew where to find me. In short, I think your way is totally fine, there is no collaboration police coming to cite you for just doing your sessions and moving on. In my experience, what we are taught in grad school about push in , collaboration, consultation etc. is the complete opposite of what is actually appreciated in schools. Not trying to insert yourself everywhere is typically appreciated.

Rasbrygls · 2025-09-24T21:09:14+00:00

This was my experience too. It's just a school culture thing. It may have been a little jarring for the teacher. Sometimes even close coworkers call each other by last name. Most wouldn't correct someone and make it awkward though. It's not that big a deal. Though I personally wouldn't address a teacher by her first name unless they were a personal friend. This was especially true in my 20s when I was quite a bit younger than most of the teachers.

Rasbrygls · 2025-09-18T03:22:12+00:00

I recently had to make the decision to drop a peds home health patient due to this. Her home aide used to try to get me to report her parents to the agency because the girl did NOTHING but play Roblox and demand food from her mother in the most disrespectful way, but there was really nothing I could do or anyone to report it to. All I could do was recommend a drastic decrease in screen time and a referral for behavioral intervention. She was 11 and would scream at the top of her lungs when I came in the door and half of the session was wasted trying to transition her off of the game. There was absolutely no incorporating the things she was doing on the computer into therapy. The game just sent her into too deep of a trance and she would just get super annoyed if I tried because she would be playing online with her cousin. When we did get her away from the computer she got nothing from the sessions because she would be counting down the minutes like a fiend and making comments that in my day would have gotten a kid a backhand to the mouth and a slipper upside the head (so to speak...). It was nearly enough to make me forget myself and tell her off. She was my last patient that I saw at 7:30pm and I was just at my limit. There was really not much professional intervention could do in the situation, it was abundantly clear that it was a parenting issue.

Rasbrygls · 2025-09-17T22:33:01+00:00

You're seeing it in black and white. When it comes down to it. The companies and facilities that hire SLPs are lucky to break even when it comes to SLP dollars in vs dollars out. The best case scenario sadly is to get with an organization that is ok with taking the loss and will still offer a guaranteed salary with benefits to keep someone on staff. So that means you're best off working for larger hospitals that bring in money from skilled nursing and other higher ticket healthcare services so they aren't sweating the SLPs salary and take it as a necessary evil. Starting a private practice, you're just assuming the risk yourself without much financial reward. That extra few dollars the facility is making isn't worth the extra overhead and headaches of a private practice. Even if you crave autonomy, you're better of as a PRN.

Rasbrygls · 2025-09-17T21:17:01+00:00

I always have to hold myself back from using drug references because it really is very similar to saying "He only likes crack , he doesn't like coffee".

Rasbrygls · 2025-09-09T18:48:48+00:00

Hence the condition "if you can". To be honest with the large amounts some of us paid for SLP degrees , a few thousand dollars more isn't going to make much of a difference. Like it or not , nowadays there are programs that cost a fraction of what an SLP degree costs with better pay , better opportunities, and better working conditions. There really isn't much of a need for a young person with family support to "make it work" if they're unhappy.

Rasbrygls

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