CFY productivity expectations: what 85% and 95% offers mean in minutes
Two percentages that measure different things, and the minutes a clinical fellow has left for notes under each offer.
Take a 30-minute unpaid lunch out of an 8-hour shift, and 450 paid minutes are left. Under CFY productivity expectations of 85%, 67.5 of those minutes remain for work other than treatment, and at 95%, 22.5 do. A job offer's target is worked out from billable minutes and paid minutes. In the US, the ASHA Clinical Fellowship standard uses a separate percentage. It requires at least 80% of the fellow's major responsibilities to be in direct client/patient contact.
This post works through two example offers, at 85% and 95%, from a question a clinical fellow asked in an online SLP forum.
Two percentages that measure different things
The Clinical Fellowship (often called the CF or CFY) is the US speech-language pathology fellowship that leads to ASHA certification. Its standard sets the length and the kind of work. It runs for at least 36 weeks of full-time experience, or the part-time equivalent.
- Full time is 35 hours a week, which comes to at least 1,260 hours (36 × 35).
- Part-time work counts if it is at least 5 hours a week.
- Hours above 35 a week can't shorten the fellowship.
- At least 80% of the fellow's major responsibilities must be in direct client/patient contact.
The 80% describes the fellow's responsibilities. It is not a share of each week's minutes, so you can't check it against a productivity report.
A productivity target compares the minutes you bill for treatment with the minutes you are paid for, as a percentage. Your employer sets it and decides how it is counted. Employers count those minutes in several ways, set out in how therapy productivity is calculated. Because the two percentages measure different things, an 80% standard and an 85% target can't be compared with each other.
CFY productivity expectations in minutes, at 85% and 95%
Example assumptions: five 8-hour shifts a week, each less a 30-minute unpaid lunch. Each day has 450 paid minutes. The paid week is 37.5 hours (450 × 5 ÷ 60), above ASHA's 35-hour full-time week.
| 85% offer | 95% offer | |
|---|---|---|
| Treatment minutes needed per day | 382.5 (450 × 0.85) | 427.5 (450 × 0.95) |
| Paid minutes left per day for everything else | 67.5 | 22.5 |
| Treatment minutes needed per week | 1,912.5 | 2,137.5 |
| Paid minutes left per week for everything else | 337.5 | 112.5 |
"Everything else" means notes, phone calls with families, walking between rooms, setting up, and team meetings. The 95% offer asks for 45 more treatment minutes a day than the 85% offer. That is 225 minutes a week, or 3.75 hours. Across a 36-week fellowship it adds up to 135 hours.
Which target fits the paid day
To find the highest target your day can hold, add up the paid minutes that go to work other than treatment. Take them off the paid day, and divide what is left by the paid day.
Example: notes take 40 minutes a day and moving between patients takes another 15. That is 55 minutes of non-treatment work, leaving 395 minutes for treatment. The highest reachable figure is 395 ÷ 450 = 87.8%.
- 85% offer. 382.5 + 55 = 437.5 minutes, which fits in 450 with 12.5 minutes to spare.
- 95% offer. 427.5 + 55 = 482.5 minutes, which is 32.5 minutes more than the paid day.
On the 95% offer, those 32.5 minutes either go into unpaid time or the target is missed. Over five days that is 162.5 minutes a week. Across 36 weeks it comes to 97.5 hours.
Under the ASHA standard, time above 35 hours a week can't shorten the fellowship. If notes keep spilling past the paid day, unpaid documentation time sets out how to raise it with a manager.
How the offers compare with published figures
ASHA surveyed US speech-language pathologists in health care in 2023 (n = 1,422). The survey's median productivity requirement was 80%, and its mean was 79%. Among clinical service providers in SNFs, 94% reported having a productivity requirement.
| Setting (US SLPs, health care, 2023) | Median requirement | Mean |
|---|---|---|
| SNF/subacute | 85% | 84.8% |
| Outpatient | 80% | 77.4% |
| Home health | 80% | 79.6% |
| Rehab hospital | 75% | 77.6% |
| General medical, VA, LTAC or university hospital | 75% | 75.8% |
| Pediatric hospital | 69% | 69.1% |
A 95% offer is above the median for every setting in the survey. Against the survey's median productivity requirement of 80%, it is 15 points higher. On a 450-minute paid day, 15 points is 67.5 treatment minutes (450 × 0.15). The survey asked only US SLPs working in health care, so it says nothing about schools or other countries. Targets in other settings and professions are covered in therapy productivity targets by setting.
Check an offer with the calculator
The therapist productivity calculator needs five entries: the shift length, any unpaid break, the treatment minutes, the target and the shift's start time. It returns the day's percentage and how far it sits from the target.
Example: enter an 8-hour shift, a 30-minute break, 400 treatment minutes, a 95% target and an 08:00 start. The calculator shows 88.9% (400 ÷ 450), 6.1 points below target. The target needs 427.5 minutes, shown as 428, so 28 are still to bill. If you bill nothing more, the latest clock-out at 95% is 15:31.
Run the same day at 85% and the 400 minutes are already above target.
Questions to ask before you accept a CF offer
- Does the target apply from the first week of the fellowship, or does it rise in steps?
- Is the target worked out on paid minutes, with the unpaid lunch taken out?
- How many minutes do notes take for this caseload, and are they written on paid time?
- Will my scheduled week stay at 35 hours or more, so the fellowship ends on time?
- What is the department's average against the target?
Take each answer back to the table above and check the minutes. For the first year in a job more widely, read the new grad therapy productivity guide.
The Clinical Fellowship is an ASHA certification requirement. Other countries' professional bodies set their own requirements, and your employer still sets any target.