SPP Weekend Reader: The Marketing Crisis, New Safety Planning Codes, Writing Off Uncollected Fees, Mental Health Parity, and Three Amazing Footrests Under $40
Welcome to this week’s SPP Weekend Reader!
As we head into the weekend, we’re giving you the TL;DR on three important headlines impacting private practices, their operations and their bottom line. Plus, we’ve got three practical product recommendations that won’t break the bank. Let’s dive in!
🚨 Top Headlines This Week
1. The Growing Marketing Crisis – Why Empty Slots Are Now the Norm, Not the Exception.
The Big Story: For the first time in decades, therapists across the country are reporting consistently unfilled appointment slots, declining inquiry rates, and a fundamental shift in how clients find and choose providers.
What was once a “therapist shortage” has transformed into strong competition for new clients driven by an over-saturation of private practices, competition from tech-platforms and AI, and marketing costs that have skyrocketed beyond what practices can afford.
The Data is Sobering:
- Therapists report their caseloads are down 20-40% compared to 2023.
- New practice launches are taking 12-18 months to reach capacity vs. 3-6 months pre-pandemic
- Google Ads conversion costs have tripled in most metro markets.
- Traditional SEO now requires “industrial scale” investment to compete with mega-directories.
A Deeper Dive:
- Market Oversaturation: More newly licensed therapists are entering private practice than ever before, flooding markets with stagnant or even shrinking demand for mental health services.
- Impact of Economic Slowdown and Benefits Cuts: With the increased economic uncertainty, growing layoffs, and insurance companies making benefits less accessible therapy is returning to the “luxury” status of 20-30 years ago. When clients have to trim expenses, therapy is one of the first cuts.
- Tech Platform Domination: VC-backed platforms like BetterHelp, Talkspace, and Cerebral continue to chip away at private practice market share with marketing budgets in the tens of millions, making it nearly impossible for individual practitioners to compete for visibility. Pre-COVID Google Ads costs were $10-30 per new client; now they’re $100+ in many markets.
- SEO Industrial Complex: Mega-directories like Psychology Today, Yelp, and ZocDoc now dominate the first page of Google results, pushing individual practice websites down to page 2 or 3 where 75% of searchers never look
Why It Matters to You: If your practice isn’t full and you’re wondering what you’re doing wrong – you’re not alone, and it’s not you. The entire landscape has shifted. The “build a website and they will come” strategy is dead. The marketing tactics that worked in 2019 are burning money without results in 2025. Therapists who aren’t adapting their marketing strategy are watching their practices slowly starve.
Key Takeaway: Marketing is no longer optional, and it’s no longer simple. Therapists need to either significantly up-level their marketing sophistication OR find ways to differentiate themselves so dramatically that traditional marketing becomes less critical. The middle ground – basic website, Psychology Today profile, hoping for the best – is no longer viable.
What’s Actually Working in 2025:
- Video Content: Short, authentic videos are driving more conversions than written content on blogs, social media, etc. Most therapists still aren’t doing this, creating opportunity for early adopters.
- Strategic Referral Networks: Building genuine relationships with other providers, medical professionals, and community organizations remains the highest ROI activity.
- Local SEO Focus: While competing nationally is impossible, dominating your specific zip code or neighborhood is still achievable.
- Alternative Income Streams: Group practices, workshops, consultation, courses, and other revenue sources reduce dependency on clinical hours.
Action Steps for This Week:
- Join our monthly Marketing for Therapists support group: The first 30 days are always free! Learn what’s working from other practice owners. Stop investing in strategies that aren’t producing and get tips from Ken Clark, whose practice books 100+ new appointments every week.
- Choose One New Marketing Channel: Pick ONE thing you’re not currently doing (video, networking events, podcast guesting, newsletter) and commit to it for 90 days.
- Get Ruthlessly Specific About Your Niche: If you can’t articulate your ideal client in one specific sentence, your marketing will never work efficiently.
- Build or Rebuild Your Referral Network: Reach out to 5 potential referral sources this week. Coffee meetings, not emails. Relationships beat algorithms.
- Consider Strategic Partnerships: Could you join an established group practice? Partner with another provider for cross-referrals? Sometimes the answer isn’t working harder, it’s working together.
- Set a Marketing Budget: Allocate 5-10% of revenue to marketing. If you’re not investing in visibility, you’re hoping for luck, not building a business
The Hard Truth: Many therapists will need to decide in 2025 whether they’re running a business or a hobby. If your practice isn’t producing the income you need, and traditional employment offers better pay with less hassle, there’s no shame in reconsidering. But if you’re committed to private practice, you MUST commit to learning marketing – or hire someone who knows what they’re doing.
2. New Billable Codes for Suicide Safety Planning – Getting Paid for Critical Work
The Big Story: Effective January 1, 2025, the Center for Medicare and Medicaid Services (CMS) has introduced two new HCPCS codes (G0560 and G0544) that provide reimbursement for safety planning interventions and post-crisis follow-up care. These are a game-changer for practices that regularly work with Medicare and at-risk clients. The hope is that commercial insurers will adopt the same codes, due to the high cost of hospital visits for self-harm.
What You Need to Know:
- G0560 (Safety Planning Interventions): Billable in 20-minute increments when you help clients develop personalized safety plans.
- G0544 (Post-Discharge Follow-up): Monthly bundled code covering four phone check-ins after crisis encounters ,
- Both codes can be billed for telehealth services
- Any practitioner authorized to treat mental illness can bill these codes – including LCSWs, LMFTs, LMHCs, and psychologists
Why It Matters to You: If you’re already providing safety planning (and you should be for high-risk clients), you may now be able to get paid for this essential clinical work. This could add thousands of dollars in annual revenue for even small practices as they care for clients with suicidal ideation or substance use disorders. However, documentation is critical – you must detail the specific elements of the safety plan and time spent.
Key Takeaway: Start training your clinical team NOW on proper documentation for these codes. Create templates that capture all required elements: warning signs identification, coping strategies, social supports, professional contacts, and environmental safety measures. Don’t leave money on the table for work you’re already doing.
Action Step: Update your EHR templates this week to include G0560 documentation fields. For G0544, set up a system to track post-crisis follow-up calls and ensure you’re capturing patient consent (which can be verbal or digital).
Sources: Medicare and Mental Health Coverage Guide from CMS, NASW Article on New Codes
3. Mental Health Parity Enforcement Suspended – What This Means for Your Claims
The Big Story: In May of 2025, the U.S. Departments of Labor, Health and Human Services, and Treasury announced they will NOT enforce the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) final rule. This follows a lawsuit from the ERISA Industry Committee (ERIC) and leaves significant uncertainty about insurance coverage protections.
What’s Changing:
- The stricter 2024 requirements for insurance plans are on hold indefinitely
- Plans were supposed to collect outcomes data showing equal access to mental health vs. medical care
- New “meaningful benefits” standards and network adequacy requirements are paused
- Federal agencies will “reconsider” their broader enforcement approach to parity
- State-level enforcement continues – some states like California are strengthening parity laws
Why It Matters to You: Without federal enforcement, insurers may feel emboldened to implement more restrictive prior authorization requirements, deny claims more frequently, and maintain inadequate provider networks for behavioral health. Translation: More claim denials, more administrative headaches, and potentially lower reimbursements.
The Silver Lining: The 2013 parity regulations remain in effect, and states can still take enforcement action. Plus, you now have data on your side – if you notice claim denial patterns that seem discriminatory compared to medical claims, document everything.
Key Takeaway: This regulatory rollback means practices need to be more vigilant than ever about tracking claim denials and advocating for clients. The burden of proof has shifted back to providers and patients.
Action Steps:
- Start tracking your denial rates by insurance payer monthly – create a simple spreadsheet
- Document any patterns where mental health claims face stricter scrutiny than medical claims
- Join your state psychological/counseling association to support state-level parity advocacy
- Consider joining or forming a provider advocacy group to collectively address parity violations
Sources: APA Services Parity Update | Sheppard Mullin Health Law
📚 Recommendations of the Week
1. Because You Deserve Comfort Too – ComfiLife Foam Footrest
Why You Need This: As therapists, we spend 6-8+ hours a day sitting in our therapy chairs, often in less-than-ideal ergonomic positions because we’re focused on our clients. This footrest is a game-changer for reducing lower back strain and improving posture during sessions. The memory foam molds to your feet, and the adjustable height means you can find your perfect position. Plus, it’s machine washable (because let’s be honest, things get spilled in therapy offices).
Perfect For: Any therapist who ends their day with aching feet, tight hips, or lower back pain. Also great for shorter therapists whose feet don’t quite touch the ground in standard office chairs.
Pro Tip: Put this in your therapy room, not your desk. You need the ergonomic support most during clinical hours, not admin time.
2. Turn Your Waiting Room into a Spa – CasaZenith Massaging Footrest
Why You Need This: Clients often arrive to sessions anxious, stressed, or fidgety. Placing a rocking footrest in your waiting area gives nervous clients something productive to do while they wait – the gentle rocking motion and massage rollers can help them self-regulate before they even enter your office. It’s also a great conversation starter and shows clients you’re thinking about their comfort from the moment they arrive.
Perfect For: Practices that see clients with anxiety disorders, ADHD, or anyone who tends to arrive wound up. Also fantastic for pediatric practices where parents are juggling kids in the waiting room.
Bonus Use: Some therapists keep one in their office for clients who find it helpful to have foot stimulation during difficult sessions.
3. Upgrade to Your Therapy Couch – Everlasting Memory Foam Foot Rest
Why You Need This: This is the footrest to place near your therapy couch or client seating. Many clients (especially shorter individuals, pregnant clients, or those with chronic pain) struggle to get comfortable during sessions when their feet don’t touch the ground. This elegant solution lets clients adjust their positioning without asking, increasing their comfort and allowing them to focus on the therapeutic work rather than physical discomfort.
Perfect For: Any practice that wants to improve the client experience. Particularly valuable for trauma-informed practices where physical comfort and client control are priorities.
The Psychology Behind It: When clients are physically uncomfortable, their nervous system stays activated and they can’t fully engage in therapy. Providing simple comfort tools signals safety and care, which deepens the therapeutic alliance.
💡 Quick Wins for Your Practice This Week
- Join Our Marketing For Therapists Monthly Group – First 30 Days is Free
- Update Your Billing Procedures: Add G0560 and G0544 codes to your billing system and train staff on documentation requirements. This could literally add $5K-$15K to your annual revenue.
- Track Your Denial Rates: Create a simple spreadsheet tracking denials by payer. With parity enforcement paused, you need data to fight back against discriminatory practices.
- Invest in Ergonomics: Your body is your business. A $25 footrest now prevents a $5,000 workers’ comp claim or chronic pain issues later.
📬 What’s on Your Mind?
How are you adapting to these challenges? Have you started using the new safety planning codes? Drop a comment below and let’s discuss strategies for navigating these changes together!
Stay tuned for next week’s roundup where we’ll cover updates on clinical documentation requirements, new teletherapy regulations, and more practical tools for building a sustainable practice.
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Disclaimer: This post contains Amazon affiliate links. If you purchase through these links, I receive a small commission at no extra cost to you. All recommendations are based on genuine value to mental health practice owners. Product prices are approximate and may vary.
