Why PPV (pay-per-visit) roles complicate your ability to predict pay

What is pay-per-visit?

Pay per visit (PPV) means that you’re only paid when you’re working directly with clients. Unlike salaried positions, your work hours and pay are therefore not guaranteed.

At first glance, this may seem simple enough– you or your boss work to fill your caseload, then you’re paid an “hourly” rate for serving these clients. However, PPV isn’t hourly work, even if some job posts list it as such. Instead, your true hourly pay will vary substantially based on other financial factors that only the employer knows, and which are infrequently disclosed in job posts. Below we’ll explain what these are and how we’re correcting for them in our SLP jobs database.

How is pay displayed at Informed Jobs?

In the Informed Jobs database, each job will have pay displayed right under the title.

• The first number in dark green is what the contract states, which could be annual or hourly.
• Then the other numbers in light green are hourly or annual estimates, because you should never take a job without knowing annual pay, plus a secondary metric (Informed Pay) that allows you to directly compare 1099 and W2 jobs. Read more on Informed Pay here.

This means all jobs will be listed as either hourly-first or annual-first, like this, depending on the contract:

For jobs that pay hourly or annually, this works great, because hourly-to-annual and annual-to-hourly calculations are pretty easy as long as you know the number of hours per week or year that you’re working, and employers are required to provide this for us.

But pay-per-visit (PPV) roles are different.

When you’re paid per visit or session, you’re neither paid hourly nor annually. However, in order to be able to predict pay, you must know what your estimated hourly and annual rates are, otherwise you’re just out here playing roulette with your wages (seriously.)

So we ask employers the questions required in order to be able to estimate it! Which means PPV roles will be displayed like this:

How do we get these numbers?

• For full-time positions, the clinic is required to disclose the range and median of their current SLPs’ pay.
• For part-time positions, we use our full employer survey, which requires all the information on variable factors listed below, to predict it the best we can. If anything is misleading or unclear, we ask the employer clarifying questions. When even they don’t know the answers, we treat PPV as an hourly rate and assume 30% of working hours are unpaid.

We lead with hourly and annual numbers only, because it allows SLPs to actually predict take-home pay, and allow all jobs in our database to be directly compared against each other. Then, true contract details (including PPV rate) are included within the body of the job post, to align with and make clear exactly how your contract will be written!

Why can’t you predict pay from PPV rates?

Because they’re not annual or hourly, and other factors affect your pay more than the PPV rate itself. This means that a job that pays $40 per visit can pay the same (or more, or less) than a job that pays $70 per visit.

Still confused? Here’s why:

Pay per task type:

• Some clinics pay you for direct time only (time spent with clients in treatment or assessment), with indirect time (e.g. paperwork time, admin time) unpaid.
• Some clinics pay you for some indirect time (e.g. report writing) but not all indirect time (e.g. emails, phone calls with parents, scheduling, or other admin).
• Some clinics say they pay you for indirect time, but in reality it’s limited with rules (e.g. 5 minutes of indirect time pay allowed per session; or one hour of indirect time paid per week).
• Some clinics have two different rates for direct and indirect time...
• Other clinics have multiple direct rates (treatment vs evaluation), and multiple indirect rates, leading to several pay rates for all the different things an SLP may do in a day. Here’s an example of what that can look like:
  • $40/30 minute session; $55/45 minute session; $65/hour session
  • $80 for evals
  • $20 for documentation and report writing
  • $15 for no-shows; $0 if client cancels with 24 hours notice
  • $10 for other admin time (emailing, cleaning up your therapy room)

This should be the point at which you, too, realize that none of this helps you know what you’ll actually be paid. But to drive this point home, we’ll keep going!

Session duration and travel time:

• Some clinics have all one session duration (e.g. all 45 minutes). Others have many session durations available to clients (e.g. 30 minutes, 45 minutes, 60 minutes).
• Some clinics pay different rates per session duration; some don’t.
• Some clinics stack your clients back-to-back. In other clinics you’ll have lots of (unpaid) gaps between clients. This can be due to a variety of factors, with the most common being variability in session durations, travel time for home health (vs remote or in-clinic work), client availability, and clinic cancellation policies (see next).

Cancellation policies:

• Some clinics pay you when clients cancel; others don’t.
• Some have cancellation policies where if a client cancels within 24 or 48 hours, you’re paid. Or you’re paid half of your session rate. Or you’re paid $10.
• Some clinics have very tight cancellation policies or a client base who in general tend to not cancel. At other clinics you can expect 30–40% of your sessions to be cancelled each week.

Expectations for paperwork, prep, and other indirect time:

• Many SLPs think it’s just about whether or not indirect time is paid. But a bigger factor is really how much indirect work you’ll need to do. Some clinics expect very little indirect time, encouraging point of care documentation where you’re writing session notes during your session. Whereas other clinics expect lots of long reports and session notes regularly shared with families.
• Some clinics also have a lot of admin duties (e.g. scheduling your own clients) and other duties (e.g. taking out the trash). At some clinics, you’ll easily be required or expected to spend upwards of 30% of your workweek in indirect time. And even if it’s not the expectation, sometimes it happens anyway.

We’ve also seen things like:

• PPV in the first three months of employment, then you’re switched to salary after that.
• Productivity bonuses on top of your session rate, which additionally makes the math very complicated.

All of these things, and more, are why PPV rates and hourly rates aren’t the same thing, and why when a job post lists that it’s pay-per-visit, you truly have no idea what you’ll be making unless you ask more questions.

How can I predict my pay from PPV job posts on other websites?

When we started Informed Jobs, we had over a dozen questions that we THOUGHT would allow us to predict pay for these jobs. Then, we realized that one of them is actually the magic question that you all should be asking employers:

What is the range (high and low) and average (median) annual pay for SLPs who currently hold this position at your company?

And that’s it! Just ask that (preferably via email, to get it in writing). Because it's the single best piece of information to really help you know what you’re getting yourself into.

Now, some of you will be afraid to ask, or will back down when employers tell you “That’s too variable or complicated to disclose…” And some employers will say that. But our data shows that >90% of employers are more than willing to disclose this information, and unfortunately you won’t know what you’ll be paid UNLESS they disclose this information.

But P.S. It’s neither too variable nor too complicated to disclose. In fact, you have a much bigger problem on your hands if your prospective employer has no idea what numbers they put into payroll last month…