Health practices
Bookkeeping for therapists and counselors
You built a practice to see clients, not to reconcile payouts. A solo practice's books should be simple. We keep them that way.
Updated October 4, 2026
In short
Therapists and counselors in private practice are usually paid through their practice software, like SimplePractice or Jane, plus some insurance payments. Costs are modest: rent or telehealth software, CE, liability coverage and supervision. We reconcile payouts, keep expenses tidy, and send a monthly profit figure. Most solo practices fit our Simple tier.
How the money moves
How money comes in and goes out
Private-pay clients pay by card through the practice software, which pays out to your bank in batches net of card fees. If you're on insurance panels, those payments arrive separately, sometimes weeks after the session.
Group practices add another layer: clinicians paid as employees or contractors, often on a percentage split.
Common problems
Where the books usually go wrong
Payouts net of fees
Your practice software's payouts are already net of card fees, which are deductible if they're recorded.
Insurance timing
Insurance pays late and sometimes partially. It helps to know what's outstanding.
The home office question
Many therapists see clients remotely from home. The home office and internet costs need clean totals for your accountant.
Every month
What we do every month
- Reconcile practice-software payouts and insurance deposits
- Record card fees as an expense, not a reduction of income
- Categorize rent, telehealth software, CE, supervision and liability coverage
- For group practices, record clinician pay and splits
- Send a simple monthly profit figure
A month of books, for example
A solo counselor sees about 60 sessions a month, mostly private pay through SimplePractice, with a few insurance clients. Each month we'd reconcile the payouts, record about $130 in card fees, match the two insurance deposits, and send her a one-page summary. It takes her five minutes to read.
Illustrative example, not a client story.
Getting started
What we need from you
- Payout reports from your practice software
- Access to your bookkeeping software and business accounts
- Home office details, once, for your accountant's purposes
Software and statements we work from
- SimplePractice
- Jane
- TherapyNotes
- Headway
- Alma
- Stripe
- QuickBooks Online
Price
What it costs
Solo therapists usually fit Simple, $200 to $400 a month. Group practices with several clinicians typically sit in Moderate.
One flat monthly price, set after the free review. See the pricing guide or estimate your tier.
Questions
Common questions
Will you see client information?
No. We work from payout totals and summary reports. Session notes and client details stay in your practice software.
I'm on Headway or Alma. Does that change things?
Only a little. Those platforms pay you directly, so we reconcile their payouts like any other income source.
Can you help me move from solo to a group practice?
We can set up the books for clinician pay and splits as you grow, and show what each clinician brings in.
Do you file my taxes?
No, your accountant does. We hand them clean books and the totals they ask for.
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