A London independent physiotherapist should charge around £84 for an initial assessment and £62 for a follow-up, based on median market data, but your exact fee must cover your local clinic rent, marketing costs and desired income. Setting the right price for your services is one of the first and most critical decisions you will make when leaving the NHS or expanding your private practice. In a major city, overheads are high, but patient demand for musculoskeletal care is also significant.
Many physiotherapists starting out struggle to balance remaining competitive with ensuring their business is actually viable. This guide breaks down the published market benchmarks, the hidden costs of patient acquisition, and the practical arithmetic of running a private clinic as a self-employed practitioner in 2026. We will look at how your potential earnings compare to standard hospital pay, what the main booking directories charge, and how to structure your price list fairly and transparently.
Contents
What the market data shows for London in 2026
When deciding what to charge, it is helpful to know what other clinics are currently billing their patients. The HMDG Private Practice Barometer, checked in September 2026, provides a reliable benchmark based on a survey of over 700 UK private clinic owners. According to this data, the UK median physiotherapy initial assessment fee is £74, with a median follow-up fee of £63.
However, location heavily influences these figures. In the capital, where commercial property rents and local business rates are higher, the average initial physiotherapy fee is £84.22, with an average follow-up of £62.15. These figures are survey averages from clinic owners, not a mandatory tariff, meaning some high-end central clinics charge significantly more, while those in outer boroughs may align closer to the national median.
You can read more about what patients expect to pay in our guide on how much private physiotherapy costs in London. While quoting a fee slightly below the average might seem like a good way to attract new patients, competing purely on price can quickly undermine your ability to cover your costs. Your primary focus should be on calculating your own operational expenses and setting a fee that makes your time sustainable.
Calculating your base costs as a sole trader
The money a patient pays you is not your take-home pay. Before you can decide your final fee, you must map out the fixed and variable costs of operating. Most independent physiotherapists begin by registering as a sole trader with HM Revenue and Customs (HMRC), which involves submitting a Self Assessment tax return each year.
Running a compliant, professional practice involves several unavoidable expenses. Here is a list of common fixed and regulatory costs you need to account for:
- Professional registration: Annual fees to remain on the HCPC register, which is a legal requirement to use the protected title of physiotherapist.
- Professional liability insurance: Often secured through membership of the Chartered Society of Physiotherapy (MCSP status).
- Data protection fees: Registering with the Information Commissioner's Office (ICO) is mandatory if you hold electronic patient health records.
- Clinic space rental: Whether you rent a room by the hour in a multidisciplinary centre or sign a lease for your own space, this is usually your largest overhead.
- Practice management software: Monthly subscriptions for booking, clinical notes and accounting systems.
In London, renting a clinical room can range widely depending on whether you commit to a full day, a month, or just pay an hourly rate on demand. If your room costs £20 an hour and you charge £84 for an assessment, your gross profit on that hour is £64 before tax and marketing. If a session is poorly attended or you have large gaps in your diary, that hourly room rate still needs to be paid, which is why your pricing must reflect the cost of empty slots.
Factoring in marketing and platform commissions
Acquiring private patients requires investment. The HMDG Private Practice Barometer reports that UK private clinics spend an average of £1,800 a month on marketing. For smaller clinics with under £100,000 in revenue, the average spend is £515 a month, representing 11.2% of their total revenue. Despite 64% of smaller clinics using Google Ads to drive traffic, the survey notes that only 25.8% of owners actually know their cost per acquisition.
If you prefer not to manage your own Google Ads, you might use booking directories, but these come with their own fee structures. Treatwell's own partner pricing page says it charges a 35% commission on first bookings made by new clients it brings you, 0% on repeat bookings, and a 2.5% plus VAT processing fee only when a client prepays online (checked September 2026). All these commissions and fees are subject to VAT, and this sits on top of a monthly plan fee. If we apply the Treatwell 35% new-client commission to the HMDG London average initial assessment fee of £84.22, the commission alone is £29.47, leaving you with £54.75 before the processing fee, VAT, your room rent and your taxes.
Limberly offers an alternative model designed specifically for independent musculoskeletal professionals. Limberly is free to list and takes 15% of the price of each session booked through Limberly, applying to both first appointments and follow-ups alike. There is no subscription and no lock-in. For example, on a £74 first appointment, the fee is £11.10. You can read more about evaluating these channels in our detailed look at getting private patients as an independent physio.
Comparing private earnings to an NHS band 6 salary
Many physiotherapists move into private practice hoping for better pay, but it is important to compare the reality of self-employed earnings with the security of an NHS salary. The NHS Health Careers site outlines Agenda for Change pay rates from April 2026. A band 6 physiotherapist earns £39,959 with under two years of experience, £42,170 with two to five years, and £48,117 with five or more years in the role.
In London, staff also receive a high cost area supplement. For Inner London, this is 20% of basic salary, with a minimum of £5,794 and a maximum of £8,746. Outer London staff receive a 15% supplement, with a minimum of £4,870 and a maximum of £6,137 (checked September 2026).
To illustrate the arithmetic, consider a band 6 physiotherapist in Inner London with three years of experience. Their base salary is £42,170, plus a 20% supplement of £8,434, giving a gross annual salary of £50,604. This NHS role includes paid annual leave, sick pay, mandatory training time, and employer pension contributions.
To match that £50,604 gross income in private practice, assuming you charge the HMDG median UK fee of £74 per initial assessment and £63 for follow-ups, you must generate significantly more than £50,604 in revenue. If your clinic room rent, marketing, software and professional fees consume 30% of your revenue, you would need to gross roughly £72,290 a year. At an average of £65 a session across a mix of new and returning patients, that requires seeing around 1,112 patients a year, or roughly 24 patients a week, assuming you take four weeks of unpaid leave. Our article on private physio earnings versus an NHS band 6 salary explores this math in greater depth.
Setting your price list structure
Your price list should be simple for patients to understand. When people are in pain, whether they are looking for shoulder pain management or rehabilitating an ankle, they want transparent costs before they book. A common approach is to split your services into two clear categories.
The initial assessment is usually your most expensive service. This session requires a detailed subjective history, objective clinical testing, a discussion of the diagnosis, and the collaborative formulation of a treatment plan. Follow-up appointments are usually shorter than the first assessment and are priced lower, as they focus on monitoring progress, adjusting exercises and providing hands-on treatment if indicated.
When deciding how to present your fees, consider the following key metrics to monitor your practice health:
- Average revenue per session: Your total monthly revenue divided by the number of sessions delivered.
- Cost per acquisition (CPA): The total amount you spend on marketing divided by the number of new patients who actually book.
- Follow-up ratio: The average number of follow-up sessions booked per initial assessment, which indicates patient retention and satisfaction.
Some physiotherapists offer discounted block bookings for a set course of treatment. If you do this, ensure your terms comply with the UK advertising rules (ASA), which require transparent pricing and clear refund policies if a patient recovers faster than expected and does not need the remaining sessions. Furthermore, never guarantee a specific recovery timeline in your marketing.
Frequently asked questions
Do I need to charge VAT on physiotherapy?
No, health services provided by registered medical professionals, including HCPC-registered physiotherapists, are generally exempt from Value Added Tax in the UK. You do not typically need to add VAT to your treatment fees, though you should consult an accountant for your specific tax setup.
Should I charge more for a home visit?
Yes, home visits take you away from the clinic, meaning you see fewer patients in a day. It is standard practice to charge a higher fee to cover your travel time, transport costs, and the convenience provided to the patient.
Are insurance network fees different from self-pay?
Yes, if you register with major private medical insurers, they often dictate a maximum fee they will pay for a physiotherapy session. You should check the provider's own page for their current fee schedules and terms before joining their network.
How often should I review my clinic prices?
You should review your pricing structure annually. Factor in inflation, changes to your room rental rates, increases in your software subscriptions, and whether your local market benchmarks have shifted over the past twelve months.
Sources
This is general information, not medical advice. A physiotherapist or GP can assess your situation.