A no-show policy is the written rule that tells clients what happens when they miss a session or cancel too late: how much notice you need, what fee applies, and how you collect it. Clients should see it and accept it before they book. Visa's guidance to merchants says clear disclosure of a cancellation policy helps you avoid misunderstandings and cardholder disputes (Visa dispute management guidelines).
This guide gives you a no-show and late-cancellation policy template to copy, with a card-on-file authorization clause built in. It then covers the fee, Medicare and Medicaid rules, telling clients, and enforcement. If you already have a policy and want the Practice Better steps for charging a missed session, one-step no-show billing covers those.
Copy the template below, replace everything in square brackets, and delete any section that does not apply to your practice. The authorization clause at the end is what lets you charge a card on file for the fees above it.
[Practice name] cancellation and no-show policy
Your appointment time is reserved for you. When you give us notice, we can offer that time to another client.
Cancelling or rescheduling. Please cancel or reschedule at least [number] hours before your appointment. You can do this from your client portal, from the link in your reminder email, or by contacting us at [phone or email].
Late cancellations. If you cancel with less than [number] hours' notice, you will be charged a late-cancellation fee of [amount, or percentage of your session fee].
No-shows. If you miss your appointment without notice, or arrive more than [number] minutes late and we cannot hold the session, you will be charged a no-show fee of [amount, or percentage of your session fee].
Exceptions. We waive the fee for [list your exceptions, for example: a medical emergency, severe weather, your first missed appointment]. Waivers are applied the same way for every client.
Packages and prepaid sessions. If you hold a package, a late-cancelled or missed session [is deducted from your package / is charged at the fee above].
How fees are collected. Fees are charged to the card you keep on file with us within [number] days of the missed appointment. You will receive a receipt by email.
Insurance. [Write this line only after reading the Medicare and Medicaid section of this guide and checking your payer contracts. Delete it if you do not bill insurance.]
Card-on-file authorization. I authorize [practice name] to store my card through [payment processor] and to charge it for late-cancellation and no-show fees under this policy, up to [amount] per appointment. I understand I will receive a receipt for every charge. I can update my card or withdraw this authorization at any time by [contacting us in writing at email], and withdrawing it means [what happens to future bookings, for example: I will pay at the time of booking instead].
Client name: ____________ Signature: ____________ Date: ________
The template above covers the eight parts a no-show policy needs: the notice window, a definition of a late cancellation, a definition of a no-show, the fee for each, the exceptions, how the fee is collected, how clients cancel or reschedule, and the client's acceptance.
| Part | What it answers for the client |
|---|---|
| Notice window | How many hours ahead do I have to cancel to avoid a fee? |
| Late cancellation | What counts as cancelling too late? |
| No-show | What counts as a missed appointment, including arriving very late? |
| Fee | How much will I be charged for each? |
| Exceptions | When is the fee waived? |
| Collection | How and when will the fee be charged? |
| How to cancel | Where do I cancel or reschedule, and by what deadline? |
| Acceptance | How did I agree to this? |
Each part closes a question a client would otherwise ask after the fee lands. Leave the exceptions unwritten, for example, and you end up deciding every waiver case by case.
Set the fee from your own numbers: what a session earns you, and whether you can refill a slot that opens with short notice. We have found no published benchmark for wellness and therapy practices that we can cite, so treat any figure quoted elsewhere as someone else's number.
Four fee structures cover the options:
| Structure | How it works | Fits a practice where |
|---|---|---|
| Flat fee | One set amount for every missed or late-cancelled session | Session prices are close to each other across services |
| Percentage of the session fee | A set share of the booked session's price | Services range widely in price and length |
| Full session fee | The client pays the full booked price | A missed slot cannot be refilled at short notice |
| Deposit kept | The deposit taken at booking covers the fee | You already take a deposit at booking |
Practice Better lets you require full payment or a deposit at booking, set per service (scheduling), so the deposit option needs no separate charge.
Three questions help you pick a number:
If you see Medicare or Medicaid patients, read the next section before you set the amount.
No, if you are enrolled as a Medicaid provider. A 1995 letter from the Health Care Financing Administration (HCFA, now CMS), issued by its Chicago regional office to relay central-office policy, states that Medicaid does not permit providers to bill program recipients who miss scheduled appointments, because a missed appointment is part of a provider's overall cost of doing business (HCFA Regional State Letter 36-95 on HHS's guidance portal; archived copy). Check your state Medicaid agency's provider bulletins as well, since the state administers your Medicaid agreement.
Yes, under two conditions set by CMS. Your missed-appointment policy has to apply equally to Medicare and non-Medicare patients, and the amount has to be the same for both. Medicare does not pay missed-appointment charges, and CMS says they should not be billed to Medicare (Medicare Claims Processing Manual, chapter 1, section 30.3.13).
These CMS rules speak to patients in those programs. The Medicare manual addresses physicians and suppliers charging Medicare beneficiaries, and the 1995 letter addresses providers billing Medicaid recipients. For any other client, start from your own written policy and the payer-contract check below.
Before you charge an insured client, check each payer contract for any term on billing a member for a missed appointment.
Collect the card through your payment system at booking, and get the client's written acceptance of the policy and the authorization before you ever charge a fee. Practice Better's guide to moving to a cash-based practice puts it plainly: to keep a credit card on file for each client, you need consent to store their card information (switching to a cash-based functional medicine practice).
A card-on-file authorization for no-show fees should name:
Where you capture that acceptance matters. Visa's guidelines ask online merchants to show the cancellation policy before checkout, with a click-to-accept checkbox or electronic signature, or near the submit button (Visa dispute management guidelines). For in-person transactions, the same guidelines say a policy in a separate contract needs a space for the cardholder's signature or initials.
In Practice Better, you have two places to capture it. A disclaimer attaches to your services, packages, and programs, and clients check a box to accept it before they can complete the booking. A form or waiver can require the client's signature, and once it is signed, you and the client both keep a copy (collecting consent ahead of sessions).
The card itself stays with the processor. With Practice Better Payments, you can require billing information at booking so you can charge cancellation fees for late cancellations or no-shows, and only Stripe stores your clients' card information (Practice Better Payments). Keep card numbers out of intake forms, notes, and email, and let the payment form collect them.
Tell clients about the policy at four points: when they book, when they complete intake, in their reminders, and at the first session.
Make the right action easy, too. Clients can reschedule or cancel from the client portal, or from the "Need to reschedule?" button in confirmation and reminder emails if you enable it (scheduling).
Adjust the tone of these two messages to your practice.
When you waive a first missed appointment:
Hi [name], we missed you at your [time] appointment today. We have waived the no-show fee this time, as our policy allows for a first missed session. Our policy asks for [number] hours' notice to cancel or reschedule, and you can do that from your client portal. Would you like to book a new time?
When you charge the fee:
Hi [name], we missed you at your [time] appointment today. As set out in the cancellation policy you accepted when booking, a no-show fee of [amount] has been charged to your card on file. Your receipt is attached. You can book your next session from your client portal.
Enforce it the same way for every client: write the exceptions down, record every miss, decide who can waive a fee, and charge promptly.
If a client disputes a fee with their card issuer, Visa's guidelines tell merchants to show that the cancellation policy was disclosed and agreed to at the time of sale, and that the cardholder did not cancel according to it (Visa dispute management guidelines). The accepted disclaimer, the booking record, and the record of the missed session cover both points.
You set up no-show fees in Practice Better in six steps.
For the wider picture of how payments, reminders, and your cancellation policy fit together, see how to automate appointment scheduling.
{{operations-checklist-for-better-group-practice-simple-text}}
No. A no-show is a client who misses the appointment without telling you. A cancellation is notice given before the appointment. Your policy sets the notice window that separates an on-time cancellation, which carries no fee, from a late one, which does.
Record the date and time of the missed session, that the client neither attended nor cancelled, any attempt you made to reach them, and whether you charged or waived the fee and why. In Practice Better, you mark the missed session directly in the system, and the same step charges the card on file or sends an invoice (one-step no-show billing).
Yes, when the client agreed to the policy before booking and the fee matches what the policy says. Two exceptions apply to government programs. If you are a Medicaid provider, CMS policy bars billing Medicaid recipients for missed appointments (CMS guidance), and for Medicare patients CMS allows the charge only when you charge non-Medicare patients the same amount (Medicare Claims Processing Manual). Check your private payer contracts before charging insured clients.
That is your call. Whichever you choose, write it into the policy so it applies to every client the same way.
You respond with evidence. Visa's guidelines for a cancelled-services dispute tell merchants to provide documentation that the cancellation policy was disclosed and agreed to at the time of sale, and that the cardholder did not cancel according to that policy (Visa dispute management guidelines). Keep the accepted disclaimer or signed authorization, the booking record, and the record of the missed session.
Yes. To keep a credit card on file for a client, you need their consent to store their card information (switching to a cash-based functional medicine practice). Get that consent in writing, in the same document as the policy the card will pay for, so the client sees the fees and the authorization together.
Copy the template, set your notice window and fee, and attach the policy to every service before your next new client books. Then let the card on file and one-step no-show billing do the collecting.
Start a free trial of Practice Better to take a card or deposit at booking, attach your cancellation policy to every service, and charge missed sessions in one step.
{{free-trial-simple-text}}
A no-show policy is the written rule that tells clients what happens when they miss a session or cancel too late: how much notice you need, what fee applies, and how you collect it. Clients should see it and accept it before they book. Visa's guidance to merchants says clear disclosure of a cancellation policy helps you avoid misunderstandings and cardholder disputes (Visa dispute management guidelines).
This guide gives you a no-show and late-cancellation policy template to copy, with a card-on-file authorization clause built in. It then covers the fee, Medicare and Medicaid rules, telling clients, and enforcement. If you already have a policy and want the Practice Better steps for charging a missed session, one-step no-show billing covers those.
Copy the template below, replace everything in square brackets, and delete any section that does not apply to your practice. The authorization clause at the end is what lets you charge a card on file for the fees above it.
[Practice name] cancellation and no-show policy
Your appointment time is reserved for you. When you give us notice, we can offer that time to another client.
Cancelling or rescheduling. Please cancel or reschedule at least [number] hours before your appointment. You can do this from your client portal, from the link in your reminder email, or by contacting us at [phone or email].
Late cancellations. If you cancel with less than [number] hours' notice, you will be charged a late-cancellation fee of [amount, or percentage of your session fee].
No-shows. If you miss your appointment without notice, or arrive more than [number] minutes late and we cannot hold the session, you will be charged a no-show fee of [amount, or percentage of your session fee].
Exceptions. We waive the fee for [list your exceptions, for example: a medical emergency, severe weather, your first missed appointment]. Waivers are applied the same way for every client.
Packages and prepaid sessions. If you hold a package, a late-cancelled or missed session [is deducted from your package / is charged at the fee above].
How fees are collected. Fees are charged to the card you keep on file with us within [number] days of the missed appointment. You will receive a receipt by email.
Insurance. [Write this line only after reading the Medicare and Medicaid section of this guide and checking your payer contracts. Delete it if you do not bill insurance.]
Card-on-file authorization. I authorize [practice name] to store my card through [payment processor] and to charge it for late-cancellation and no-show fees under this policy, up to [amount] per appointment. I understand I will receive a receipt for every charge. I can update my card or withdraw this authorization at any time by [contacting us in writing at email], and withdrawing it means [what happens to future bookings, for example: I will pay at the time of booking instead].
Client name: ____________ Signature: ____________ Date: ________
The template above covers the eight parts a no-show policy needs: the notice window, a definition of a late cancellation, a definition of a no-show, the fee for each, the exceptions, how the fee is collected, how clients cancel or reschedule, and the client's acceptance.
| Part | What it answers for the client |
|---|---|
| Notice window | How many hours ahead do I have to cancel to avoid a fee? |
| Late cancellation | What counts as cancelling too late? |
| No-show | What counts as a missed appointment, including arriving very late? |
| Fee | How much will I be charged for each? |
| Exceptions | When is the fee waived? |
| Collection | How and when will the fee be charged? |
| How to cancel | Where do I cancel or reschedule, and by what deadline? |
| Acceptance | How did I agree to this? |
Each part closes a question a client would otherwise ask after the fee lands. Leave the exceptions unwritten, for example, and you end up deciding every waiver case by case.
Set the fee from your own numbers: what a session earns you, and whether you can refill a slot that opens with short notice. We have found no published benchmark for wellness and therapy practices that we can cite, so treat any figure quoted elsewhere as someone else's number.
Four fee structures cover the options:
| Structure | How it works | Fits a practice where |
|---|---|---|
| Flat fee | One set amount for every missed or late-cancelled session | Session prices are close to each other across services |
| Percentage of the session fee | A set share of the booked session's price | Services range widely in price and length |
| Full session fee | The client pays the full booked price | A missed slot cannot be refilled at short notice |
| Deposit kept | The deposit taken at booking covers the fee | You already take a deposit at booking |
Practice Better lets you require full payment or a deposit at booking, set per service (scheduling), so the deposit option needs no separate charge.
Three questions help you pick a number:
If you see Medicare or Medicaid patients, read the next section before you set the amount.
No, if you are enrolled as a Medicaid provider. A 1995 letter from the Health Care Financing Administration (HCFA, now CMS), issued by its Chicago regional office to relay central-office policy, states that Medicaid does not permit providers to bill program recipients who miss scheduled appointments, because a missed appointment is part of a provider's overall cost of doing business (HCFA Regional State Letter 36-95 on HHS's guidance portal; archived copy). Check your state Medicaid agency's provider bulletins as well, since the state administers your Medicaid agreement.
Yes, under two conditions set by CMS. Your missed-appointment policy has to apply equally to Medicare and non-Medicare patients, and the amount has to be the same for both. Medicare does not pay missed-appointment charges, and CMS says they should not be billed to Medicare (Medicare Claims Processing Manual, chapter 1, section 30.3.13).
These CMS rules speak to patients in those programs. The Medicare manual addresses physicians and suppliers charging Medicare beneficiaries, and the 1995 letter addresses providers billing Medicaid recipients. For any other client, start from your own written policy and the payer-contract check below.
Before you charge an insured client, check each payer contract for any term on billing a member for a missed appointment.
Collect the card through your payment system at booking, and get the client's written acceptance of the policy and the authorization before you ever charge a fee. Practice Better's guide to moving to a cash-based practice puts it plainly: to keep a credit card on file for each client, you need consent to store their card information (switching to a cash-based functional medicine practice).
A card-on-file authorization for no-show fees should name:
Where you capture that acceptance matters. Visa's guidelines ask online merchants to show the cancellation policy before checkout, with a click-to-accept checkbox or electronic signature, or near the submit button (Visa dispute management guidelines). For in-person transactions, the same guidelines say a policy in a separate contract needs a space for the cardholder's signature or initials.
In Practice Better, you have two places to capture it. A disclaimer attaches to your services, packages, and programs, and clients check a box to accept it before they can complete the booking. A form or waiver can require the client's signature, and once it is signed, you and the client both keep a copy (collecting consent ahead of sessions).
The card itself stays with the processor. With Practice Better Payments, you can require billing information at booking so you can charge cancellation fees for late cancellations or no-shows, and only Stripe stores your clients' card information (Practice Better Payments). Keep card numbers out of intake forms, notes, and email, and let the payment form collect them.
Tell clients about the policy at four points: when they book, when they complete intake, in their reminders, and at the first session.
Make the right action easy, too. Clients can reschedule or cancel from the client portal, or from the "Need to reschedule?" button in confirmation and reminder emails if you enable it (scheduling).
Adjust the tone of these two messages to your practice.
When you waive a first missed appointment:
Hi [name], we missed you at your [time] appointment today. We have waived the no-show fee this time, as our policy allows for a first missed session. Our policy asks for [number] hours' notice to cancel or reschedule, and you can do that from your client portal. Would you like to book a new time?
When you charge the fee:
Hi [name], we missed you at your [time] appointment today. As set out in the cancellation policy you accepted when booking, a no-show fee of [amount] has been charged to your card on file. Your receipt is attached. You can book your next session from your client portal.
Enforce it the same way for every client: write the exceptions down, record every miss, decide who can waive a fee, and charge promptly.
If a client disputes a fee with their card issuer, Visa's guidelines tell merchants to show that the cancellation policy was disclosed and agreed to at the time of sale, and that the cardholder did not cancel according to it (Visa dispute management guidelines). The accepted disclaimer, the booking record, and the record of the missed session cover both points.
You set up no-show fees in Practice Better in six steps.
For the wider picture of how payments, reminders, and your cancellation policy fit together, see how to automate appointment scheduling.
{{operations-checklist-for-better-group-practice-simple-text}}
No. A no-show is a client who misses the appointment without telling you. A cancellation is notice given before the appointment. Your policy sets the notice window that separates an on-time cancellation, which carries no fee, from a late one, which does.
Record the date and time of the missed session, that the client neither attended nor cancelled, any attempt you made to reach them, and whether you charged or waived the fee and why. In Practice Better, you mark the missed session directly in the system, and the same step charges the card on file or sends an invoice (one-step no-show billing).
Yes, when the client agreed to the policy before booking and the fee matches what the policy says. Two exceptions apply to government programs. If you are a Medicaid provider, CMS policy bars billing Medicaid recipients for missed appointments (CMS guidance), and for Medicare patients CMS allows the charge only when you charge non-Medicare patients the same amount (Medicare Claims Processing Manual). Check your private payer contracts before charging insured clients.
That is your call. Whichever you choose, write it into the policy so it applies to every client the same way.
You respond with evidence. Visa's guidelines for a cancelled-services dispute tell merchants to provide documentation that the cancellation policy was disclosed and agreed to at the time of sale, and that the cardholder did not cancel according to that policy (Visa dispute management guidelines). Keep the accepted disclaimer or signed authorization, the booking record, and the record of the missed session.
Yes. To keep a credit card on file for a client, you need their consent to store their card information (switching to a cash-based functional medicine practice). Get that consent in writing, in the same document as the policy the card will pay for, so the client sees the fees and the authorization together.
Copy the template, set your notice window and fee, and attach the policy to every service before your next new client books. Then let the card on file and one-step no-show billing do the collecting.
Start a free trial of Practice Better to take a card or deposit at booking, attach your cancellation policy to every service, and charge missed sessions in one step.
{{free-trial-simple-text}}
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