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Behavioral Health & Psychiatry

The CPA firm built for therapists and mental health practices

Accounting, tax strategy, payroll, and fractional-CFO leadership for solo and group psychiatry, psychology, and counseling practices, from one CPA-led team.

CPA-led · Nationwide & fully remote · Flat monthly fees
A mental health counseling session

Works with the tools you already use

QuickBooks OnlineGustoSimplePracticeTherapyNotesADP
The Problem

Therapy practice finances are not general accounting

Insurance and private-pay mixes, W-2 vs 1099 clinicians, and S-corp decisions all move real money. A generalist rarely sees them.

Payer and private-pay mix

Insurance reimbursement and cash-pay hit your cash flow differently. We model the mix so slow payers never catch you short.

Clinician classification

W-2 vs 1099 for associate therapists is a top audit trigger. We classify defensibly before the state ever asks.

S-corp and reasonable comp

Once profit clears a reasonable salary, an S-election can cut self-employment tax, done right and documented.

What You Get

Everything your behavioral-health practice needs behind the front desk

One integrated, CPA-led team handles the entire business side, so your energy stays on care.

Explore all services →
  • Monthly bookkeeping and reconciliations
  • Clear monthly financial statements you actually read
  • Proactive, year-round tax strategy
  • S-corp and reasonable-compensation analysis
  • Full-service payroll and 1099 filings
  • Clinician classification handled defensibly
  • KPI dashboards and specialty benchmarking
  • A dedicated CPA-led team, never a call center
How It Works

From messy books to a real financial partner

A proven path, built around your clinical calendar. Most practices are fully live in 30–45 days.

01

Assess

A free deep-dive into your books, entity, comp, and pain points.

02

Build

We clean up the books, set your chart of accounts, and stand up the compliance calendar.

03

Run

Monthly financials, payroll, and tax filings delivered like clockwork.

04

Grow

Quarterly strategy, benchmarking, and proactive tax planning.

The economics

What we watch in a mental health practice

Every specialty has a handful of numbers that decide the year. These are the ones we put in front of you monthly, with the planning ranges we work against.

Mental health practice scorecardPlanning ranges
Clinician cost as a share of revenue50–60%
Billable hours per clinician per week22–28
Net collection rate96%+
Days in accounts receivable25–35
Cancellation and no-show rate< 8%
Cash-pay share of revenueVaries widely
Operating margin15–25%

Why these three matter most

  • W-2 or 1099 is the defining questionA therapy practice built on contractors is the most common classification exposure we see, and in California the ABC test rarely favours the practice.
  • Superbills are not billingOut-of-network practices still need collections tracked against sessions delivered, or revenue quietly leaks.
  • What we watch monthlyBillable hours, utilisation against target, net collection rate, and clinician cost.

These are planning ranges we work against in engagements, not published survey data. Healthy figures vary by payer mix, geography, entity structure and stage — a practice outside a range is not necessarily unhealthy, it is a question worth asking. We benchmark you against your own trend first.

Questions

Mental Health practice FAQs

Often, once your profit comfortably exceeds a reasonable salary. We run the numbers before you elect so it actually saves money and holds up under scrutiny.
Under most state rules, associates seeing your clients on your schedule are W-2. We classify defensibly and run compliant payroll.
Yes. We work in QuickBooks Online alongside SimplePractice, TherapyNotes, and the major EHRs, and manage the setup for you.
Get Started

Ready to hand off your practice back office?

Book a free, no-pressure practice assessment. We will review your books, entity structure, and tax posture and show you exactly where we would add value. You will speak with a CPA, never a call center.

Book Your Free Assessment →See How It Works