You’ve been there. Waiting for a client who just doesn’t show. 

And the frustration that follows:

You’ve lost time and money that you can’t get back.

The impact of missed appointments on medical practices is widely known. Research from the BJGP reveals that:

  • 15.2% of practice appointments are typically missed
  • Missing appointments was most often attributed to work or family obligations, forgetting, and transportation issues

This figure might not look like much, since you only anticipate a few appointment no-shows each week. 

But think about this scenario:

If you charge £50 for an appointment in your practice, two no-shows a week can cost your business over £5,000 annually. 

And that figure doesn’t account for the operational and salary costs associated with planning and postponing that clinic visit.

Many healthcare practices are now charging no-show fees for missed appointments or cancelling at the last minute, or levying a 100% termination fee if a customer fails to appear.

What is a “no-show” appointment?

Any client who fails to show up for a planned appointment is referred to as a “no-show” or “DNA” (Did Not Attend).

When a client cancels less than 24 hours before their scheduled appointment, it is considered a “same-day cancellation.”

“Late arrival” refers to any client who comes 15 minutes after the scheduled appointment.

What is a cancellation fee?

If a patient fails to show up for an appointment they are charged a cancellation fee.

Costs of cancellation are treated like any other contract condition. 

In order to book an appointment with you, a patient must agree to your requirements, so specify these in your T&Cs or your consent forms. 

Generally, more precise terms are easier to enforce.

Can I really charge for a no-show appointment?

Cancellations and no-shows are big problems for private practices.

Besides taking up your time, they also have a negative effect on your finances.

If your client signed an agreement, or entered into an agreement by making an appointment with you after reading your terms and conditions, then you can legally demand payment from them. 

So, what’s the answer? 

Should you start billing no-show fees?

Below are the advantages and disadvantages you should know:

Pros of charging for a no-show appointment

With no-show rates ranging between 5% and 8%, collecting no-show fees may seem like a no-brainer.

Fees for no-shows have the following benefits:

  • They will decrease your financial losses

Let’s say your appointments cost £50 for one hour of treatment time. 

You might not want to charge non-attendees the full whack if they don’t turn up, but 50% would be reasonable. 

Although a £25 no-show charge does not entirely compensate for the missed appointment, it does help to lessen the damage.

There are a couple of ways you can bill them for this:

  • You can notify your clients of your no-show fee policy at the time of booking, and issue an invoice to them if they don’t show up (or add it to their next bill).
  • You can take a 50% deposit from them when they book, and make them aware that this is non-refundable if they do not turn up, or if they cancel within 24 hours of when the appointment is due to take place. 

This means you’ll also cover some of the service, staff, rent, and utility costs you may have incurred for the appointment.

  • They reduce no-shows almost entirely

In almost all cases, a no-show charge will encourage your patients to keep their scheduled appointments.

Patients will appreciate your time, and nobody likes extra expenses!

  • The value of your time will be clear to clients

Patients sometimes don’t understand that not showing up for an appointment could be inconvenient for their clinician.

If you are treating patients for a one-off complaint, and they wouldn’t need to come back and see you again, this can also make it a lot easier for clients to simply not turn up. 

When you introduce a no-show fee and a 24-hour advance cancellation policy, patients will perceive your practice differently, and take their appointment booking more seriously.

Cons of Charging for No-Shows

Although charging no-show fees has numerous benefits, it is not a perfect option for everyone. 

There are a few disadvantages to consider, including:

  • It may be challenging to collect

If you can’t take a payment in advance, it can be a nightmare collecting no-show fees for missed appointments.

One way around this is to automatically bill them as per your practice’s terms of service if you have access to their credit card information.

You could also add the charge onto their next invoice if they come back.

  • You may lose the clients who no-show regularly

A no-show charge may reduce the number of missed appointments, but it may also result in losing a certain type of client.

If the policy changes suddenly, it could be a deal-breaker for busy patients who miss their appointments all the time.

By charging a no-show fee, you may push them elsewhere rather than encouraging them to keep their appointments.

  • They may have skipped an appointment due to a genuine emergency

Although rare, there may be times when a client has had to cancel due to a genuine and serious emergency.

To get around this one, you could consider giving first offenders a second chance, or a reduced fee to what you would charge to second or third offenders of your policy. 

Other ways to reduce your no-shows

Reminding clients about their appointments by text message or email is an excellent way to reduce no-shows and late cancellations.

By doing so, you allow them to cancel in advance if needed. Plus: you can remind them about your cancellation policy at the same time! 

Consider sending two texts prior to their appointment – one a week in advance and another a day before. This keeps upcoming appointments in their minds and reminds them to cancel if needed.

By setting up an online practice management system, patients will be sent automated reminders via SMS and email so you don’t even need to remember to do it!

Offering online booking is another great way to make sure your clients show up to their appointments on time.

They can schedule themselves in, pay in advance and save their appointment straight to their calendar. The booking system will even send out their reminder text messages for you!

Need more info on how to reduce your no-shows? Check out our recent webinar recording here: 

FREE no-show policy templates 

Make your cancellation and no-show policy clear by using one of our templates in your appointment confirmation and reminder emails:

Giving first offenders a second chance

If it’s their first offence, you might give the client a one-time, no-fee missed appointment, keeping in mind that some clients may have a genuine emergency:

In the event you are no longer available for your appointment, please provide 24 hours notice.

If you cancel within 24 hours, you won’t be charged.

Is this your first time?

We understand that emergencies happen. We do not charge a fee for first-time no-shows or late cancellations. After that, you will be charged a 100% cancellation fee for appointments missed or cancelled without 24 hours notice.

This allows us to continue offering the highest level of care to clients on the waiting list and ensure they can make an appointment.

100% no-show fee

If a client fails to show up for an appointment without giving at least 24 hours notice, you can charge them the full appointment fee:

If you miss or cancel your appointment without 24 hours notice, you will be responsible for 100% of the appointment fee.

If you are unable to attend an appointment, please let us know in advance so we can reschedule.

Thank you for your help with this matter. It allows us to maintain high service levels at the practice.

50% no-show fee

If you’ve looked at your finances and feel like you can meet the client halfway, you might charge a 50% cancellation fee. 

The bonus here is that you’ll appear empathetic to your clients’ needs while covering some of your costs:

We’ll charge you 50% of the appointment fee if you don’t show up or if you cancel without 24 hours notice.

In the event you cannot make your appointment, please let us know in advance and we will be happy to reschedule for you.

So, should you charge no-show fees?

Thinking back to all of the benefits and drawbacks, should you charge your patients a no-show fee?

There is no one correct answer. This is an incredibly personal decision that is influenced by a wide range of factors:

Can you take prepayments for your appointments?

If not, the difficulty and cost of recovering the no-show charge may not be worthwhile.

How many patients fail to show up regularly?

If a lot of your patients frequently skip appointments, driving them away could result in you losing more money.

How many of your booked appointments are cancelled?

If the proportion is high, a no-show charge will significantly reduce the number of no-shows.


If your practice has a high rate of no-shows and appointment cancellations, it’s essential that you consider charging a no-show fee so that you can maintain the financial health of your practice.

Whatever option you choose, make your policies clear so clients won’t be surprised by a bill. Having to pay money that wasn’t budgeted can be really stressful.

Remember that you might lose out on significant benefits if your clinic management software doesn’t allow you to send timely and automated reminders to your patients letting them know about any no-show policy you have in place.

Having the right software in place will also allow you to take payments in advance of a client’s booking, so that you don’t need to chase it up afterwards should they not attend. 

Don’t settle for mediocre practice management software that wasn’t built for the unique needs of healthcare providers. Choose our software to experience the unparalleled benefits of a solution that was designed specifically with your needs in mind.

If you’d like to know more about how WriteUpp can help you reduce no-shows and streamline the overall management of your practice, just grab us for a quick chat.

The button is just there in the bottom right corner of your screen.


Ellie is WriteUpp’s in-house Content Creator. Her research and writing for private practitioners focuses on marketing, business growth, data security, and more. She also hosts WriteUpp’s podcast The Healthy Practice; the show that guides practitioners in the early stages of their careers through every aspect of practice management. Outside of work Ellie writes a mental health blog, studies mindfulness and is a keen nature photographer.