The cost to produce an assessment report is almost entirely clinician hours, and the write-up is the biggest chunk you can actually compress. A full psychoeducational assessment runs somewhere between thirteen and nineteen clinician hours end to end. At published association rates, the report-writing portion alone is worth more than most practices realise they're absorbing.
I'm not a clinician and I don't run a practice, so I'm not going to tell you what your work is worth. What I do have is a year of conversations with psychologists about where their weeks go, and the arithmetic those conversations kept pointing at. This is that arithmetic, with the published sources it rests on.
The cost of an assessment isn't in the testing room. It's in what comes after it.
What does an assessment actually cost in clinician hours?
Published Alberta clinic schedules break a full psychoeducational assessment into roughly four blocks: one to two hours of clinical interview, six to nine hours of testing, four to six hours of report writing, and about two hours for the debrief. That totals thirteen to nineteen clinician hours per assessment, with the write-up sitting at roughly a quarter to a third of delivery time.
Neuropsychological work is heavier. One Alberta practice publishes that its process "is about 16 hours and involves the client for about 5-9 of those hours" — which means seven to eleven hours happen with no client in the room. That back-office remainder is the part nobody sees, nobody schedules well, and nobody enjoys.
Now put a rate on it. The Psychologists' Association of Alberta publishes a recommended fee schedule of $235 per hour, effective 01 January 2025, and the page notes there will be no increase for 2026. Multiply the seven-to-eleven back-office hours by that rate and you get roughly $1,645 to $2,585 of clinician time per assessment that never has a client sitting across from it.
Why is the number practices quote so different from the number they feel?
Here's the tension I find most interesting, and I want to lay it out honestly rather than pick the more dramatic side.
Published clinic schedules put report writing at four to six hours. But when I ask psychologists directly — in calls, not surveys — the number that comes back is consistently ten to fifteen hours for a full write-up. Those two figures are both real, and the gap between them is the whole story.
A published fee schedule describes the time a practice can defensibly bill. The ten-to-fifteen-hour figure describes the time the work actually takes, including the parts that don't fit in a billing code: the re-reading, the false starts on the integration section, the version that got scrapped, the evening spent making a paragraph say the thing precisely. I've written before about why psychological report writing takes so long, and this is the ledger version of that.
So the honest framing isn't "reports cost X." It's that reports cost a billable X and an unbilled Y, and Y is where the frustration lives. If you want your own number rather than mine, the only way is to measure it — a fortnight of honest time-tracking on the write-up alone tells you more than any benchmark.
Where does the money actually leak?
From the practices I've talked to, four places, in rough order of size.
The unbilled write-up hours. Where a practice bills a flat fee — and in Alberta the psychoeducational market commonly sits between $2,000 and $4,500, often flat — every hour past the estimate is absorbed. A flat fee turns a long report into a pay cut.
The backlog. Reports that haven't gone out are revenue that hasn't landed and a client who is still waiting. Worse, a backlog compounds: the report you write three weeks late takes longer, because you have to reload the case.
Rework. A report that comes back for revision arrives after you've mentally closed the file. Reloading costs more than the edit does.
Capped intake. This is the big invisible one. Several practices told me they simply stop taking assessments past a certain point in the term — not because testing capacity is full, but because the write-up queue is. That's a revenue ceiling set by a documentation bottleneck.
A backlog isn't a queue of paperwork. It's a queue of revenue and a queue of waiting families.
What is the write-up bottleneck actually costing in throughput?
Try it as a per-clinician calculation, because that's the unit practices staff against.
If a full assessment consumes roughly sixteen clinician hours and a clinician delivers forty to fifty a year — about one a week — that's 640 to 800 hours, a large share of a clinical year, on assessments alone. The write-up portion of that, at a quarter to a third, is somewhere between 160 and 270 hours per clinician per year.
That's the number worth sitting with. Not the cost of one report — the fact that a meaningful slice of every assessment clinician's year goes into prose. Whether that slice should be smaller is a business judgment I'm not going to make for you. But it's the largest single compressible block in the delivery model, and it's the reason the practices I speak to look at drafting tools at all.
What actually moves the number?
Three things, in the order the practices I've talked to found them.
Measure the write-up separately from the assessment. Most practices track assessment time as one lump. Split the write-up out and the bottleneck becomes visible and arguable.
Attack the blank page, not the structure. A better template reorganises work that was never the constraint. I've written about why report templates don't solve the problem — the hours live in the writing, not the headings.
Decide what the freed hours are for. This is the one practices skip, and it decides whether any of it shows up in the books. Freed hours become revenue only if they're deliberately pointed at more assessments, a shorter waitlist, or an earlier finish. Otherwise they quietly refill.
If the write-up is where your ceiling is, that's the part Soma is built to compress — a first draft you review and sign, with the clinical judgment staying entirely yours. I'd rather you measured your own baseline first, though. A number you produced is worth more in a business decision than a number I did.
— Ian
