TL;DR
Offset processing costs by offering patients a 3% discount for paying with cash or check — card patients pay your standard posted price, nothing changes for them
Legal in all 50 states under federal law — no registration required, no state restrictions
Not surcharging — you're rewarding cash payers with a discount, not penalizing card payers with a fee
One-time setup — raise your fee schedule 3–4%, update your financial policy, and post signage
Most patients pay by card anyway — for them, checkout is identical to today
What Is the Cash Discount Program?
The Cash Discount Program is a payment model that allows your practice to offset credit card processing costs by offering patients who pay with cash or check a small discount — typically 3% — off the posted price. Patients paying by card pay your standard posted rate. Patients paying with cash or check pay a slightly lower amount.
The framing is important: your posted prices are your standard prices, and cash is rewarded with a discount. You are not adding a fee for card payments — you are offering an incentive for cash. This distinction is both the legal foundation of the program and the key to patient reception.
Done right, it's a straightforward program that puts more revenue back in your practice without surprising patients or creating friction at checkout.
The Real Cost of Accepting Credit Cards
Processing fees are easy to overlook — they show up as small percentages on a statement, not as a single large expense. But they add up fast.
The average dental office processed nearly $45,000 in credit card payments per month in 2023 — nearly triple what it was in 2009. At a typical processing rate of 2–3%, that translates to roughly $900–$1,350 leaving your practice every single month just to accept card payments. Over the course of a year, that's $10,800–$16,200. Over a career, it's a significant sum.
Card usage in dental offices has only increased over time, accelerated by COVID-era preferences for contactless payment and the growing practice among insurance companies of paying claims via virtual credit cards. The costs that once felt manageable are now a meaningful line item for most practices.
The Cash Discount Program is one of the most practical tools available to recover those costs.
A Brief History: How Cash Discounts Became Legal Nationwide
Cash discount programs have been legal under federal law since 2011, thanks to the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 and its Durbin Amendment. The Durbin Amendment explicitly prohibits payment card networks from restricting a merchant's ability to offer discounts for cash and check payments.
Before this legislation, card network agreements often prevented merchants from treating cash and card customers differently. The Durbin Amendment changed that, establishing that a discount offered for cash — as long as customers are clearly informed — is protected under federal law.
Gas stations have used this model for decades, displaying two prices at the pump: a cash price and a card price. The Durbin Amendment extended that same right to every business in every state.
Cash discount programs are legal in all 50 states. There are no state-level restrictions on offering a discount for cash, unlike surcharge programs, which face restrictions in several states.
For more detail on the Durbin Amendment and its implications for merchants, the Federal Trade Commission publishes guidance at ftc.gov.
Cash Discount vs. Surcharge: What's the Difference?
These two terms are often used interchangeably, but they are legally and practically different — and the distinction matters.
Surcharging means adding a fee on top of your posted price when a patient pays by card. The listed price is considered the base price, and card users pay more. Surcharging is subject to state-level restrictions, is prohibited in some states, and requires compliance with specific card brand rules around disclosure and registration. It also tends to land poorly with patients — research suggests more than 60% of customers would reconsider returning to a merchant that surprised them with a surcharge at checkout.
Cash discounting means your posted price is the standard price — the price card users pay — and patients who pay with cash or check receive a reduction. No fee is added; a benefit is offered. This model is legal in all 50 states, requires no registration with card networks, and is far less likely to create patient friction because it is framed as a positive rather than a penalty.
| Cash Discount | Surcharge |
Legal in all 50 states | ✅ Yes | ❌ No — restricted in some states |
Card network registration required | No | Yes |
Applied to debit cards | No | No (prohibited) |
Patient perception | Rewarding cash payers | Penalizing card payers |
Prahsys program type | ✅ This one | — |
The Prahsys Cash Discount Program is a true cash discount model. Your posted prices are your card prices, and a 3% discount is applied at checkout for cash and check payments. The technology handles the calculation automatically — your staff does not need to manually adjust totals.
Important Note: While cash discount programs are legal nationwide, insurance provider contracts may include clauses that affect how you structure fees for insured patients. Review your provider agreements or consult your attorney before making changes to your fee schedule.
How to Prepare Your Practice
Adopting the Cash Discount Program works best when paired with a one-time fee schedule update. Here's the standard approach used by practices across the country.
Adjust Your Fee Schedule
The most effective implementation raises posted fees by approximately 3–4% across the board. This means:
Your new posted prices reflect what card-paying patients have always effectively cost you to serve, with processing factored in
Your cash discount brings patients back to roughly what your old prices were
Your practice stops absorbing the cost of processing on every card transaction
Example: A procedure previously billed at $200 is updated to $206. A patient paying by card pays $206. A patient paying by cash or check receives a 3% discount and pays $200 — the same amount they would have paid before. Your practice nets more on card transactions without the patient experience changing for cash payers.
This is not a price hike for its own sake — it's a structural correction that aligns your posted fees with the true cost of delivering care. Many practices have been effectively subsidizing card processing for years without realizing it.
Update Your Financial Policy
Your written financial policy should reflect the program clearly. A straightforward disclosure might read:
"Our posted fees reflect standard pricing for services rendered. Patients who pay by cash or check at the time of service receive a 3% cash discount applied at checkout."
Have patients sign or acknowledge your financial policy at intake and whenever it changes. Clear, upfront disclosure is both a compliance requirement and good patient communication.
Post Your Signage
Compliant signage must be displayed at your front desk and point of sale. This is a requirement for program activation and a key part of patient transparency. Prahsys provides both a printable PDF and a physical acrylic sign, both of which include all required disclosure language.
What to Expect From Patients
Most patients respond well to the cash discount model — especially when it is communicated clearly before they reach the checkout counter. The signage and upfront disclosure do the work.
A few things worth knowing:
Most patients pay by card anyway. Research consistently shows that the majority of dental patients pay by credit or debit card. For those patients, nothing changes at checkout — they pay your posted price as always.
Cash payers feel rewarded, not penalized. Framing matters. Patients who do pay with cash or check receive a visible discount at checkout. That's a positive experience, not a friction point.
Transparency eliminates surprises. The only scenario where patients react negatively to payment programs is when they feel blindsided. Clear signage and an updated financial policy prevent that entirely.
Is It Right for Your Practice?
The Cash Discount Program is a strong fit for practices that:
Process a meaningful volume of card payments each month (most dental offices do)
Want to recover processing costs without reducing service quality or staff
Are willing to update their fee schedule and financial policy as a one-time setup step
Prefer a simple, legally straightforward model over the complexity of surcharge programs
It may require more consideration for practices that:
Have insurance contracts with specific fee-schedule restrictions (review those agreements first)
Have not updated their fee schedule in several years and want to consult with an advisor before making changes
Serve a patient population where even a small cash discount may create confusion without thoughtful communication
If you're unsure, the best first step is a conversation with your account manager. Prahsys is here to help you evaluate whether the program is a fit before you commit.
Ready to Get Started?
If the Cash Discount Program sounds like the right move for your practice, the enrollment process takes just a few minutes in the Prahsys Merchant Dashboard.
Need Help? Contact Prahsys Support at [email protected] or call 1 (833) 222-6834.