Psychologist fees in South Africa: what to charge per session

How much do psychologists charge in South Africa?

The most reliable benchmark is what medical schemes pay, because those rates are published. Across eight major schemes in 2026, the average rate for an individual session was:

Most private practitioners set their cash rate at or above the medical aid average. The full table, including group rates, is in our guide to what registered counsellors and psychologists should charge.

What a psychologist charges per session depends on

• Registration category. Psychologists’ rates are about double those of registered counsellors, across every scheme.
• Session length. Rates rise in ten-minute bands. A 50-minute session and a 60-minute session are billed differently.
• Type of service. Assessments, couples work, reports and court work are usually priced separately from individual therapy.
• Location. Fees in the main metros tend to be higher than in smaller towns.
• Experience and specialisation. Practitioners with specialised training often charge above the average.

Medical aid rate, or your own rate?

This is the central decision. You can charge the scheme rate, or you can charge your own rate and let the client claim back what their scheme pays.

Many practices mix the two: the scheme rate for medical aid clients and a cash rate for everyone else. Whatever you choose, the client must know before the first session what they will owe.

A method for setting your fee

1. 1Add up your monthly practice costs: rooms, insurance, registrations, software, supervision and CPD.
2. 2Decide what you need to take home before tax.
3. 3Estimate the paid sessions you can realistically hold in a month, allowing for leave and cancellations.
4. 4Divide the total you need by those sessions. That is your minimum fee.
5. 5Compare it with the medical aid average for your category. If your minimum is well above it, look again at your costs or your caseload.

Our guide to how much psychologists earn in South Africa works through the income side of the same sum.

The rules on fees

You are free to set your fee, within limits the HPCSA’s ethical rules place on every practitioner.

• Fees must be disclosed clearly before the service is provided. Informed consent includes cost.
• Fees must not exploit a client in a vulnerable position.
• What you put on a medical aid claim must accurately reflect the service provided: the right tariff code, the right date and the right duration.
• You may charge a reduced fee. If you do, apply it consistently and record it on the invoice.

Put your fee, your payment terms and your cancellation policy in your consent form. A missed session generally can’t be claimed from a scheme, so the client needs to have agreed to that charge in advance. See our guide to reducing no-shows.

Reviewing your fees

Schemes adjust their rates at the start of each year. A fee that is never reviewed falls behind inflation without anyone deciding that it should.

• Review once a year, when the new scheme rates are published.
• Give existing clients written notice, at least a month ahead.
• Update your consent form, your website and your booking page together.
• Look at your actual results first: how full the diary was, and how much of what you invoiced was paid.

Practice Insights shows income per available hour, which tells you more about whether a fee is working than the fee itself. And when rates are set once, as they are in Wholistic, a change carries through to your invoices, website and booking page together.