Key takeaways
- Patient financing has no subscription: the practice pays a merchant discount fee (a % off each financed sale), while the patient pays APR, 0% promo, or deferred interest.
- Most lenders (Cherry, PatientFi, CareCredit, Affirm and more) pay the practice in full up front and own the default risk; Denefits is a collect-over-time model with payment protection.
- Merchant fees range widely: Cherry ~1.7-1.9%+ and PatientFi industry-low at the bottom, healthcare cards in the middle (CareCredit ≈10% on 0%-deferred), and general BNPL like Sunbit (~5-9%) and Affirm/Klarna (~5.99%+$0.30) at the top.
- On a $4,000 case, a ~2% aesthetics plan costs the practice ~$80 while a ~10% 0%-deferred card plan costs ~$400 - a swing that dwarfs any subscription; 0%-to-patient plans cost the practice the most.
- Deferred-interest cards (CareCredit, Alphaeon ~27-33% retroactive APR) are a real patient risk versus true-0% products like Cherry; watch origination fees too (LendingUSA up to ~8%).
- All figures are directional - merchant fees here are negotiated, volume-tiered, and often undisclosed, so confirm live rates and patient APRs with each lender.
Patient financing flips the usual software-pricing question on its head. There is no monthly subscription to budget for - in fact, most lenders cost the practice nothing to sign up. Instead, the practice pays a merchant discount fee: a percentage taken off the top of every financed transaction. The patient, meanwhile, may pay APR or deferred interest on the loan they take out. Understanding both sides - what you pay and what your patient pays - is the whole game. Browse every option in our patient financing category. The figures below are directional list prices from public vendor information; merchant fees in this space are routinely negotiated and undisclosed, so always confirm live rates. For how we evaluate tools, see our methodology.
Who pays what - practice vs patient
There are two parties paying in any financed transaction, and it helps to keep them separate.
The practice pays a merchant discount fee. With most lenders - Cherry, PatientFi, CareCredit, Alphaeon Credit, Sunbit, Wisetack, Affirm, and Klarna - the lender funds the loan and pays the practice in full, up front, usually within a couple of business days, then keeps a percentage as its fee. The lender, not the practice, owns the risk that the patient stops paying. That up-front, no-recourse funding is the core promise of the model.
Denefits works differently: it is a collect-over-time platform with payment protection rather than an up-front funder. The practice is paid as the patient pays, and Denefits layers on protection against missed payments. That changes your cash-flow profile and where default risk sits, so read its terms closely.
The patient pays interest - either a true APR on an installment loan, a $0-interest promotional plan, or deferred interest that can snap back retroactively. More on that below.
Merchant discount fee by model
Here is how the merchant discount fee stacks up, grouped by lender type. These are the percentages the practice gives up on each financed sale.
| Model | Provider | Typical merchant discount fee |
|---|---|---|
| Lowest (aesthetics-built) | Cherry | ~1.7%-1.9%+ per transaction |
| Lowest (aesthetics-built) | PatientFi | "Industry-low"; up to 3.5% cash back on some plans |
| Healthcare cards | Alphaeon Credit | ~3.15%-3.5%, tiered by volume |
| Healthcare cards | CareCredit | ~1.9%-14.9% (≈10% common on 0% deferred-interest plans) |
| POS / general BNPL | Wisetack | 3.9% (up to 9.9% on extended 0% plans) |
| POS / general BNPL | Sunbit | ~5%-9% per transaction |
| POS / general BNPL | Affirm / Klarna | ~5.99% + $0.30 per transaction |
| POS / general BNPL | GreenSky | ~5%-10% per transaction |
| Undisclosed | HFD / LendingUSA | Undisclosed / "competitive" - quote required |
The pattern is clear: aesthetics-built lenders like Cherry and PatientFi sit at the low end, healthcare credit cards land in the middle but spike on 0%-to-patient plans, and general-purpose BNPL providers charge the most per transaction. The single biggest swing isn't which provider you choose - it's which plan within a provider, because subsidizing 0% interest for the patient is paid for by the practice's merchant fee.
A worked example - financing a $4,000 treatment
Say a patient finances a $4,000 treatment. Watch what the merchant fee does to your net deposit:
| Plan | Merchant fee | Fee in dollars | Practice nets |
|---|---|---|---|
| Aesthetics-built (~2%) | 2% | ~$80 | ~$3,920 |
| 0% deferred-interest card (~10%) | ~10% | ~$400 | ~$3,600 |
On a low-fee aesthetics plan you give up about $80. On a 0%-deferred card plan where you subsidize the patient's interest-free period, you give up roughly $400 - five times as much on the same sale. That $320 swing dwarfs any software subscription you'd pay in this category. And it confirms the rule of thumb: 0%-to-patient plans cost the practice the most, because someone has to fund that free interest, and it's you. The fee is also the line item that scales: do twenty $4,000 cases a month and the difference is $6,400 a month.
Patient APR & deferred interest
What the patient pays varies just as widely, and the distinction that matters most is true 0% versus deferred interest.
- Pay-in-4 / 0% installments. Short BNPL plans (often via Affirm and Klarna) split a purchase into four payments at no interest to the patient.
- True 0% APR. Cherry offers genuine 0% promotional plans where the patient never accrues interest if they pay as agreed - and even if a balance remains, there is no retroactive interest bomb.
- Deferred interest. Healthcare cards like CareCredit and Alphaeon Credit advertise "0% if paid in full within X months," but if the patient misses the deadline, interest is charged retroactively from day one at roughly 27%-33% APR. This is the patient risk to flag.
- Origination fees. Some installment lenders, such as LendingUSA, can charge an origination fee up to ~8% that reduces what the patient effectively borrows.
Deferred interest is a genuine patient-experience risk: a patient who thinks they got "0%" and then gets hit with months of back-interest at 30% will not blame the card - they'll blame your front desk. True-0% products like Cherry avoid that landmine entirely.
Hidden and qualitative costs
The headline percentage isn't the whole story. Weigh these too:
- Chargebacks and disputes. Disputed or reversed transactions carry handling overhead and, depending on the lender, possible clawbacks - real exposure on high-ticket aesthetic cases.
- Who owns default risk. With up-front funders (Cherry, PatientFi, CareCredit, Affirm, and most others) the lender absorbs non-payment. With Denefits' collect-over-time model, the risk profile shifts toward the practice, mitigated by its payment protection.
- Approval rates. A low fee is worthless if few patients qualify. Sunbit and Cherry market high approval rates; healthcare cards can be stricter. More approvals means more closed cases.
- Soft vs hard credit pull. Most aesthetic lenders pre-qualify with a soft pull that doesn't ding the patient's credit, converting better at the chair than a hard-pull application.
Budgeting by practice
Don't budget the merchant fee in isolation - budget it against the incremental revenue financing unlocks. If offering financing closes a $4,000 case that would otherwise have walked, a $400 fee bought you $3,600 you wouldn't have had. The right question is conversion lift, not raw fee.
Then decide whether to absorb or pass the fee. Most med spas absorb it as a cost of doing business, the way they absorb card-processing fees, because surcharging financing can chill the very conversions you're paying for. A high-volume practice running mostly low-fee aesthetics plans may absorb comfortably; a practice leaning on 10% 0%-deferred plans should price that into its treatment menu deliberately.
How to lower your cost
- Steer toward low-fee plans. Default to true-0% or low-merchant-fee aesthetics products (Cherry, PatientFi) and reserve expensive 0%-deferred card plans for cases that genuinely need them.
- Negotiate the rate. Merchant fees here are negotiable and volume-tiered (Alphaeon openly tiers by volume). Once you can show monthly financed volume, ask for a better rate.
- Use more than one lender. Pairing an aesthetics-built lender with a healthcare card widens approvals while letting you route each case to the cheapest plan that fits.
- Mind approval and conversion. A slightly higher fee with far higher approvals can net more revenue than a cheap rate that declines half your patients.
- Confirm everything live. Because these fees are negotiated and often undisclosed, the published ranges are only a starting point.
Ready to choose? Walk through our buying guide to match a lender to your case mix, compare the two category leaders head-to-head in Cherry vs CareCredit, and explore every option on the patient financing pillar. And always confirm current merchant fees and patient APRs directly with each lender - the figures here are directional, negotiated, and frequently undisclosed.
Frequently asked questions
Does patient financing cost the practice a subscription?
No. Unlike most med spa software, patient financing has no monthly subscription - signing up is typically free. Instead the practice pays a merchant discount fee, a percentage taken off the top of each financed transaction (roughly 1.7% on aesthetics-built lenders like Cherry up to 10%+ on 0%-deferred healthcare card plans). The patient separately pays APR or deferred interest on their loan. Always confirm the live merchant rate, since these fees are negotiated and often undisclosed.
Who pays the merchant fee, and who pays the interest?
The practice pays the merchant discount fee; the patient pays the interest. With most lenders - Cherry, PatientFi, CareCredit, Affirm, Klarna and others - the lender funds the loan, pays the practice in full up front, keeps a percentage as its fee, and owns the risk if the patient defaults. Denefits is the exception: it collects over time with payment protection rather than funding up front, which shifts the cash-flow and risk profile toward the practice.
Why do 0% interest plans cost the practice more?
Because someone has to fund the patient's interest-free period, and on a 0%-to-patient plan that someone is the practice - through a higher merchant fee. On a $4,000 case, a ~2% aesthetics plan costs the practice about $80, while a ~10% 0%-deferred card plan costs about $400. The patient sees 0%, but the practice absorbs roughly five times the fee. That's why 0%-to-patient plans are the most expensive option for the practice.
What is deferred interest and why is it a patient risk?
Deferred interest plans, common on healthcare cards like CareCredit and Alphaeon Credit, advertise 0% if the balance is paid in full within a set promotional window. If the patient misses that deadline, interest is charged retroactively from day one at roughly 27%-33% APR. A patient who believed they had 0% can suddenly owe months of back-interest. True-0% products like Cherry avoid this entirely - there's no retroactive interest even if a balance remains.
How can a med spa lower its financing costs?
Steer cases toward low-fee, true-0% or aesthetics-built plans (Cherry, PatientFi) and reserve expensive 0%-deferred card plans for cases that truly need them. Negotiate your merchant rate once you can show volume - fees here are negotiable and often volume-tiered, as with Alphaeon. Offer more than one lender to widen approvals and route each case to the cheapest plan that fits. And weigh fee against conversion: a slightly higher fee with much higher approval rates can net more revenue.
