How Does a Sliding Scale Work?

Low income patients may qualify to pay less for medical services on a sliding scale.

A sliding scale pricing system bases prices for a product or service on a purchaser's ability to pay instead of setting a fixed price for all customers. Sliding scales assist customers or medical patients on low or fixed incomes.



Fees based on a sliding scale take into account a person's income and often other factors such as family size. Typically, they must fill out a questionnaire, provide photo identification and show proof of income to determine if they qualify for a reduced price.


Some medical clinics or practitioners offer sliding scales so patients who need health care can afford to use their services. Patients might go without care, or wait until a problem becomes a medical emergency, if they had to pay the full price.



According to the National Health Service Corps, sliding scale fees should be non-discriminatory and maintain patient privacy. NHSC tells its member clinics to use federal poverty guidelines to set fees. For example, a clinic might charge a small fee or nothing at all to patients below the poverty line, and full price to patients whose income is 200 percent above the poverty line.