Group Practices
Bookkeeping for group mental health practices with associates and staff. Clinician pay recorded the way you agreed to it, payroll run on schedule, 1099s prepared, and profit visible per clinician.
Where Group Practices Get Complicated
Most group practices start with one decision. You had more referrals than hours, so you brought on an associate. Then a second one. Somewhere in there you hired someone to handle intakes and scheduling so the phone stopped ringing during sessions. The clinical work you love is still there, and now there is a payroll to run, a contract supervisor to pay, and a bank balance that moves in ways it never used to.
The books change shape when a practice grows like that. Money comes in from several caseloads and goes out in several different forms of pay. Your own income sits somewhere in the middle of all of it. Until the numbers are separated by clinician and by role, the practice’s real profit stays a mystery, and the bank balance is not going to solve it for you.
Who This Covers
Who This Covers
Group therapy and counseling practices with roughly two to ten people, whether the team is all clinicians or a mix of clinicians and admin support. LMFTs, LPCs, LCSWs, psychologists, prescribers, and the owner-clinician who is still carrying a caseload while running the place.
What Makes These Books Different
What Makes These Books Different
Pay leaves the practice in more than one shape. Salaried associates, percentage splits, hourly admin help, contract supervisors on a 1099. Each one belongs in the books a specific way, and each one needs to line up against the revenue that clinician actually produced.
What I Handle
The foundation is steady monthly work. Deposits and expenses get categorized, bank and credit card accounts get reconciled, and you get reports that show where the practice stands. That is my Full-Service Bookkeeping service, and in a group practice it includes recording associate compensation the way you actually agreed to it, whether that is a salary, an hourly rate, or a percentage of what the clinician collects.
If your payroll system is already up and running, I take the pay runs off your plate through Full-Service Payroll. I want to be straight with you about the boundary there. I run payroll systems that already exist, and I do not do the initial payroll setup. At year end I prepare and file 1099s for your contract clinicians, supervisors, and vendors. Whether a given person belongs on a W-2 or a 1099 is a call for your attorney or your tax professional. Once that call is made, the books record it correctly and stay consistent all year long.
Payroll and Contractor Pay
Payroll and Contractor Pay
Pay periods processed on schedule for your W-2 staff and clinicians, with the numbers landing in the books the same week. Contractor payments tracked all year, with a W-9 collected when someone starts, so year-end forms are a short task rather than a January scramble.
Margin by Clinician
Margin by Clinician
Revenue grouped by clinician alongside the compensation tied to it, so you can see what each caseload contributes after that person is paid. This is the report that answers the question almost every group practice owner asks me, which is whether the next associate would actually help.
What Usually Goes Sideways
The thing I hear most often from group practice owners is that the practice is busier than it has ever been and the bank account does not show it. Usually the books are the reason. All the clinician pay sits in one lump on the profit and loss, admin wages sit right next to it, and the owner’s draws are folded in with everything else. The totals add up correctly and the story is missing.
The contractor side causes the other half of the trouble. Payments to a contract supervisor or a 1099 associate go out of the checking account through the year with no W-9 on file and no consistent category behind them. January arrives and nobody can say for certain who was paid what. Add a few months of transactions that never got categorized, and your tax preparer ends up asking questions the practice cannot answer.
Pay That Cannot Be Traced
Pay That Cannot Be Traced
When all clinician compensation lands on one expense line, there is no way to see which caseloads carry the practice and which ones barely cover the pay attached to them. Hiring and raise decisions get made on a feeling about how full the schedule looks.
A January You Did Not Plan For
A January You Did Not Plan For
Contractor totals reconstructed from bank statements. Missing tax IDs chased down by text message. Forms going out later than they should. All of it is avoidable with a little discipline during the year, and none of it is worth the stress it causes.
What Changes
You open the monthly reports and see the practice clinician by clinician. Revenue, the pay attached to it, and what is left. Admin cost shows up as its own line. Your own compensation shows up as its own line. When you start thinking about adding another associate or adjusting a split, you have last quarter’s real numbers in front of you.
Payday stops living in your head. Contractor records stay current, so year-end forms go out on time. Your books stay tax-ready for whoever prepares your return, since I do not prepare returns myself and I want your preparer working from clean numbers. If any of this sounds like your practice, book a consultation with me. Tell me what your team looks like right now, and I will tell you plainly what I can take off your plate.
Growth You Can Actually See
Growth You Can Actually See
Adding a fourth clinician feels different once you know what the third one contributed after pay. You can plan a raise, revisit a split, or hold steady for a quarter with real figures behind the decision rather than a hunch about how busy everyone seems.
You Work With Me
You Work With Me
I spent more than fifteen years as a licensed nurse in mental health before I did this work, so your terminology and your day to day do not need explaining to me. When you send a question, you get me. Nothing about your practice gets handed off to a rotating team.
Helping the People Who Help Others
Let's Start With
a Short Conversation
Tell me where your books stand right now, even if the honest answer is that nobody has looked at them in a year. I'll ask a few questions and give you a clear idea of how I can help.
