Browser-only practice economics · no account
What do no-shows cost you, and what does a cancelation policy actually recover?
A missed hour is paid for in full and never invoiced. Enter your fee, your week, the share of sessions that are missed or canceled late, and the policy you run: the page prices the hole after tax, what the policy recovers from the clients it may lawfully be applied to, and what each empty hour is worth — with the Medicare and Medi-Cal rules where they belong.
Your week and your policy →Your week and your policy
Eleven numbers, all yours. The rules decide only who may be charged.
Scheduled sessions are what the calendar holds. No-shows and late cancelations are the shares of them that do not happen — your own records, not an average. Reschedules are the share of those hours you fill later in the same week. The policy is the share of the fee you charge for a missed session and the share of those charges you actually collect. The Medi-Cal share of the caseload is excluded from recovery by regulation. Costs are monthly running costs before tax.
At other no-show rates
The same week and policy as the no-show share moves.
| No-shows | Empty hours a year | Take-home lost | Policy recovers |
|---|---|---|---|
| 4% | — | — | — |
| 6% | — | — | — |
| 8% | — | — | — |
| 10% | — | — | — |
| 12% | — | — | — |
| 15% | — | — | — |
| 20% | — | — | — |
Empty hours a year, take-home lost to them, and take-home the policy recovers, at your fee, sessions, weeks, late-cancel rate, reschedule rate, policy, collection rate, Medi-Cal share, costs and filing status.
Who may be charged
Two published rules, one contract you have to read yourself.
CMS’s MLN Matters article MM5613 (effective 1 October 2007): a physician or supplier may charge a Medicare beneficiary for a missed appointment provided the policy applies equally to non-Medicare patients and the amount is the same. The charge is “for a missed business opportunity”, not for a service, so the assignment and limiting-charge rules do not apply; Medicare itself never pays it and it is not billed to Medicare.
The state’s mental-health letter DMH 02-07 (19 November 2002): Mental Health Plans and their providers may not bill Medi-Cal beneficiaries for missed appointments, and the letter names Title 9 CCR §1810.365 as the general prohibition on billing beneficiaries for services and related administrative charges. The calculator applies zero recovery to the Medi-Cal share of the caseload.
A network or panel contract may allow, cap, or forbid charging members for missed sessions. This page does not guess at any payer’s terms; read the contract, and put the policy in the informed-consent paperwork the client signs before the first session.
How it computes
Three years of revenue, and the differences between them.
Scheduled × weeks × (no-show + late-cancel) is the sessions lost; the reschedule share of them is filled later in the week; the rest are empty hours. Empty hours × fee is the gross hole.
Revenue with no policy (the sessions that happened), with the policy (plus what it collected), and with nothing missed at all — each less twelve months of costs, each through self-employment tax on 92.35% of profit, half deductible, the qualified business income deduction, then the 2026 federal and the 2025 California schedules, the engine every money page here shares.
Empty hours × the share of the caseload that may be charged (everyone but Medi-Cal) × your charge × the share of charges you collect. The take-home difference between the with-policy year and the no-policy year is what the policy is worth; divided by empty hours, what it recovers per hour.
A payer contract that forbids or caps the charge; a client who leaves over the policy; the clinical effect of charging, in either direction; hours filled from a waitlist rather than a reschedule.
Then what
The hole is priced. These pages price what surrounds it.
The week as people
The caseload calculator
Attendance, cadence and tenure turned into active clients and the consults a year that keep the week full.
The fee itself
The fee-increase calculator
How many clients a raise can lose and still pay, and the disclosure rule for every license.
The reduced-fee slots
The sliding-scale calculator
What each reduced session costs after tax, and what carries it.
Where every figure came from
Sources.
Who may be charged
- CMS, MLN Matters MM5613 — charges for missed appointments: permitted for Medicare beneficiaries when the policy and amount apply equally to non-Medicare patients; billed to the patient, never to Medicare; read 4 September 2026
- California Department of Mental Health letter 02-07 (19 November 2002), hosted by DHCS — MHPs and their providers may not bill Medi-Cal beneficiaries for missed appointments; Title 9 CCR §1810.365
The engine
Every computed figure comes from what the reader entered and the two rules above. No-show and cancelation rates are the reader’s own; the page carries no average. Sole proprietor; married filing separately is not modeled.
