February 2026
Transparency in Billing and Fee Structures
Question:
There seems to be a lot of variation in the field of SLP and audiology on how much to bill for services and products. Some audiology clinics provide free services, and the client then only pays for the products. While other clinics will charge for both services and products. There is also a high variation for the cost of the same products between the audiology clinics. The same seems to be true in SLP, where there is a large range of prices for the same services depending which clinic you attend. Do you have any guidance on how much we need to charge for services and/or devices?
Answer:
ACSLPA doesn’t provide specific guidance on private practice fee structures. The Health Professions Act (Section 3(2) states “A college may not set professional fees, provide guidelines for professional fees or negotiate professional fees on behalf of some or all of its regulated members”. However, regulated members working in private practice and navigating aspects of fees and billing need to ensure compliance with ACSLPA’s Standards of Practice (e.g. SoP 4.7) and Code of Ethics.
The standard 4.7 on fees and billing states: “A regulated member of ACSLPA, working in a private practice environment, ensures that fees for products/services are justifiable and that clients are informed of fee schedules prior to delivery of services”. For a fee to be justifiable the fee should be shown to be reasonable or defensible. It would be reasonable to ensure services are accessible to all and registrants may consider sliding scales for fees as long as these are justifiable. Fees should only be charged for services that were actually provided. Cancellation fees may be considered as long as these are reasonable and agreed to in advance by the client.
The standard also highlights that all fees for services and products are fully disclosed and consent to fees is documented before services are delivered. This ensures that clients are aware of the costs involved prior to accepting services. The timing of this will vary depending on the environment where the services are provided and consent for fees can be obtained at the initial assessment as part of the initial informed consent, or prior to implementation of new services or products. Should fee structures or charges change, the client should be notified within a reasonable period before the change is implemented.
Registrants should also be able to explain their fee structure or breakdown their fee structure should clients ask. Addressing these aspects ensures that clients have adequate information to make informed decisions and provides them an opportunity to clarify misunderstandings and obtain additional information if required.
The ACSLPA guideline on informed consent states that consent must be provided voluntary and free of coercion and intentional misrepresentation. Informed consent can be written or verbal but must be documented in the client’s file. In cases of communication barriers, it is the responsibility of the clinician to ensure the client understands the information provided to them.
Once services are provided, regulated members are required to:
- Provide clients with accurate and detailed invoices regarding fees in a timely manner,
- maintain accurate financial records related to fees and services provided, and
- correct any fee or billing discrepancies in a timely manner.
Regulated members are reminded that they may contact the College if they have questions or need further clarification. Please do not hesitate to reach out at any time using the Contact Us form.
If there is a conflict or discrepancy with the information or advice set out on this webpage and the information contained in a more official ACSLPA document, then the information contained in the more official ACSLPA document applies and not the information or advice set out here. For the purposes of this disclaimer, ACSLPA’s more official documents include the governing legislation (including the Health Professions Act and the Speech-Language Pathologist and Audiologist Profession Regulation) as well as ACSLPA’s Bylaws, policies, Standards of Practice, Code of Ethics, manuals and/or any other official document approved by Council, a statutory committee or a college official. Persons interacting with ACSLPA are responsible for reviewing and familiarizing themselves with the relevant information contained in ACSLPA’s official documents.