Treatwell charges a 35 percent commission on first bookings from new clients, a 2.5 percent processing fee on online prepayments, and a fixed monthly plan fee, which together significantly reduce the profit margin of your initial physiotherapy assessments. If you are starting or running an independent practice, understanding exactly how these platform fees affect your take-home revenue is a vital step in deciding your marketing strategy.

Many physiotherapists moving into private practice look for fast ways to fill their diaries. Aggregator platforms offer an immediate presence, but their pricing models are built for high-volume, repeat-visit salon services rather than clinical musculoskeletal care. When you rely on these channels, the cost of acquiring a single patient can quickly outstrip traditional marketing methods.

This guide breaks down the published fee structure, applies it to current UK physiotherapy pricing benchmarks, and compares the resulting income against standard NHS pay scales. By looking at the arithmetic, you can make an informed choice about whether third-party booking apps belong in your practice.

Contents

The Treatwell fee structure explained

To understand the true cost to your business, you must look at every component of the platform's pricing model. Treatwell's own partner pricing page states that it charges a 35 percent commission on first bookings made by new clients it brings you (checked September 2026). This is the headline figure most practitioners focus on.

However, the 35 percent commission is only one part of the financial arrangement. The platform's revenue model relies on multiple overlapping charges that affect different stages of the patient journey.

According to their published terms, the complete pricing model includes the following elements:

  • A 35 percent commission applied to any initial booking from a new client discovered through the platform.
  • A 0 percent commission on repeat bookings from that same client in the future.
  • A 2.5 percent plus VAT processing fee applied whenever a client chooses to prepay for their appointment online.
  • A fixed monthly plan fee to use the software and remain listed on the platform, which you pay regardless of how many bookings you receive.
  • The stipulation that all commissions and processing fees are subject to VAT.

The monthly plan fee is not stated as a fixed amount in the public text on their pricing page, so you must contact them directly for a quote based on your practice size. This monthly overhead applies before you have even seen your first patient.

Calculating the cost of an initial assessment

To see how this affects a real physiotherapy business, we can apply the 35 percent commission to average UK pricing. The HMDG Private Practice Barometer, a survey of over 700 UK private clinic owners, reports a UK median physiotherapy initial assessment fee of £74 (checked September 2026).

If you charge exactly the UK median of £74 for an initial assessment, a 35 percent commission takes £25.90 straight out of your revenue. This leaves you with £48.10 before any other deductions are made. You are giving away a third of the value of your most time-intensive appointment.

This deduction is particularly steep because the initial assessment is typically the longest session you will spend with a patient. It involves taking a full medical history, conducting physical tests, discussing goals and writing up detailed clinical notes.

If you practice in an area with higher living costs, your fees may be higher. The HMDG survey reports a London average initial physiotherapy fee of £84.22. A 35 percent commission on this fee equals a deduction of £29.47, leaving the clinician with £54.75 before processing fees and VAT.

How VAT affects your commission

When calculating costs for physiotherapists, it is easy to forget about tax on business-to-business services. Treatwell clearly states that all its commissions and fees are subject to VAT.

As a medical professional providing healthcare services, your physiotherapy treatments are generally exempt from VAT. You do not charge VAT to your patients. However, Treatwell is providing you with a marketing and software service, which is a standard-rated supply for VAT purposes.

Let us return to our worked example using the HMDG median initial assessment fee of £74. The base 35 percent commission is £25.90. You must then add 20 percent VAT to this commission amount, which is an extra £5.18. Your total deduction is now £31.08.

From your £74 patient fee, your actual take-home revenue drops to £42.92. You have lost nearly 42 percent of the patient's payment to platform fees and taxes before accounting for your room rent, insurance or travel costs.

The hidden impact of processing fees

The deductions do not always stop at the commission and its associated VAT. Many patients prefer the convenience of paying for their appointment at the time of booking. Treatwell applies a 2.5 percent processing fee when a client prepays online.

This 2.5 percent fee is also subject to VAT. Using the £74 median fee again, a 2.5 percent charge equals £1.85. Adding 20 percent VAT brings this specific processing cost to £2.22 per booking.

If a new patient finds you on the platform and chooses to prepay, the arithmetic looks like this:

  • Patient pays: £74.
  • Treatwell 35 percent commission plus VAT: £31.08.
  • Prepayment processing fee plus VAT: £2.22.
  • Total platform deductions: £33.30.
  • Your final take-home revenue: £40.70.

In this scenario, a booking platform removes almost half of your gross revenue for an initial assessment. If you are comparing different platforms, you should carefully review how we check physios and how different directories structure their payment gateways.

Comparing platform fees with average marketing spend

Platform platforms argue that their commission is simply a marketing cost. To evaluate this claim, we must look at what independent physiotherapy clinics actually spend on marketing. The HMDG Private Practice Barometer reports that UK private clinics spend an average of £1,800 a month on marketing (checked September 2026).

However, that average includes large multi-site clinics. For independent practitioners and small businesses, the figures are different. The same HMDG survey notes that clinics with under £100,000 in revenue spend an average of £515 a month on marketing, which represents roughly 11.2 percent of their revenue.

If a small clinic allocates 11.2 percent of its budget to marketing, giving up 35 percent of a new patient's first fee to an aggregator represents a massive premium. The platform model shifts the risk away from monthly ad budgets, but it does so at a very high unit cost.

Furthermore, the HMDG data shows that 64 percent of smaller clinics use Google Ads to acquire patients. With independent campaigns, the cost per acquisition is fixed by local competition rather than a blanket percentage, meaning your profit margin on high-value services remains intact.

Benchmarking against NHS Agenda for Change pay

Many physiotherapists entering private practice do so to increase their earning potential or gain flexibility after leaving the NHS. It is helpful to compare the take-home pay from highly commissioned private work against stable NHS salaries.

NHS Health Careers gives Agenda for Change pay rates from April 2026. A Band 6 physiotherapist earns £39,959 with under two years of experience, rising to £42,170 with two to five years, and £48,117 with over five years. A Band 7 role pays £49,387, £51,932, or £56,515 depending on experience.

If you work in London, the NHS adds a high cost area supplement. Inner London staff receive an extra 20 percent of their basic salary (a minimum of £5,794 and a maximum of £8,746), while Outer London staff receive 15 percent (minimum £4,870, maximum £6,137).

As a worked example, an experienced Band 6 physiotherapist in Outer London earns a basic £48,117 plus the 15 percent supplement, which is capped at £6,137, giving a gross salary of £54,254. This comes with paid annual leave, sick pay, and employer pension contributions.

To match this financial security in private practice, your hourly revenue must be substantially higher than an NHS hourly rate to cover your own annual leave, pension, room rental, and business insurance. Accepting a platform model that leaves you with £40.70 from a £74 assessment makes it very difficult to build a sustainable business that genuinely outperforms an NHS Band 6 or Band 7 package.

The reality of patient retention in physiotherapy

The primary defence of a high initial commission is the promise of 0 percent commission on repeat bookings. The platform model assumes that you take a hit on the first appointment, but make your profit on subsequent visits.

This works well for haircuts or nail appointments, where clients return every few weeks indefinitely. Physiotherapy is entirely different. An HCPC-registered professional aims to discharge the patient once their musculoskeletal issue is resolved. You are actively working to reduce the patient's need to see you.

For example, if you see a patient for a straightforward ankle sprain, you might perform an initial assessment and two follow-up sessions. The HMDG median follow-up fee is £63. If the patient does not prepay, your revenue is £42.92 (after the 35 percent plus VAT commission on the £74 assessment), plus £63, plus £63. Your total take-home is £168.92 from a gross billing of £200.

The blended cost of acquiring that patient is effectively 15.5 percent of the total treatment value. If the patient only needs one follow-up, the blended cost percentage is even higher. Relying on a long sequence of repeat bookings to offset an expensive initial commission contradicts the clinical goals of modern physiotherapy.

Why physiotherapy differs from standard consumer services

Using a beauty and wellness platform for medical care presents operational challenges alongside financial ones. Physiotherapists are regulated healthcare professionals. You must adhere to strict standards regarding patient data, clinical records, and informed consent.

When a patient books through an aggregator, the platform holds their data. As a practitioner, you must ensure you have a secure, compliant way to store clinical notes that meets HCPC standards of conduct, performance and ethics and Information Commissioner's Office rules. You often end up running two systems: the booking platform for appointments and a separate clinical software package for medical records.

Furthermore, patients searching on wellness platforms are often looking for immediate symptom relief, such as a sports massage or general relaxation. They may not understand the difference between a massage therapist and a chartered physiotherapist.

If a patient books you expecting a full-body massage and you instead perform a clinical assessment for back pain, it can lead to mismatched expectations. You might want to read our article asking How much does private physiotherapy cost in London? for more context on how patients perceive value in clinical settings.

Alternative patient acquisition strategies

Independent physiotherapists have many other ways to build a caseload without surrendering 35 percent of their initial assessment fee. Building your own digital presence requires more initial effort but offers far greater long-term rewards.

Focus on strategies that build your own brand equity rather than a platform's. When a patient searches for a physio, you want them to find your website, read your credentials, and book directly into your clinical diary system.

Effective alternatives for independent practitioners include the following steps:

  • Setting up a well-optimised Google Business Profile to capture local search traffic in your immediate area for free.
  • Running targeted local Google Ads, allowing you to control exactly how much you spend per click and measure your own cost per acquisition.
  • Building relationships with local sports clubs, gyms, and running groups to generate word-of-mouth referrals.
  • Joining dedicated healthcare directories that charge a flat, transparent subscription fee rather than a percentage commission on your clinical labour.
  • Creating clear, helpful content on your own website about specific conditions you treat, helping patients make informed decisions before they book.

By investing in your own marketing, you retain full control over your pricing structure and patient data. The HMDG data shows that only 25.8 percent of private clinic owners know their exact cost per acquisition. By managing your own marketing, you can become one of the practice owners who truly understands their business numbers.

Choosing the right technology stack is a major decision when leaving the NHS or expanding a private clinic. While third-party aggregators offer a tempting shortcut to visibility, the 35 percent commission, added VAT, processing fees and monthly subscriptions create a heavy financial drag on an independent physiotherapist's earnings.

This is general information, not financial or legal advice. An accountant or business advisor can assess your specific situation and help you calculate the exact impact of different booking systems on your practice.

Limberly is opening across the UK for independent physiotherapists, starting with London, Manchester and Sussex.