What makes ABA practice books harder than a therapy practice's?
A solo therapy practice usually has one clinician, a short list of recurring expenses, and revenue that arrives in a pattern you can recognize after a month or two of watching it. An ABA practice changes all three of those at once, and that is really the whole answer.
The first difference is staffing. You have behavior technicians and analysts on the schedule, often at different hourly rates, sometimes with travel between homes and schools, sometimes with overtime, and usually with more turnover than a talk therapy practice ever sees. That means payroll is a real event every pay period and it is almost always the largest number in your books. It also has to happen on time whether or not the money for that work has landed yet. I run payroll for practices whose payroll system is already set up, and I do it on schedule so nobody on your team is waiting and wondering.
The second difference is volume. One ABA client can receive more service hours in a single week than a therapist delivers to their entire caseload. Multiply that across your clients and technicians and you get a lot of service lines behind every dollar that shows up in the bank. Payments tend to arrive as remittances covering many dates of service at once, with adjustments and occasional takebacks mixed in, so a single deposit rarely matches a single tidy invoice. Reconciling that means working from your billing system’s reports and making the bank agree with them. Your billing stays where it belongs, in your billing system with the person who handles it. My job is to make sure the books tell the truth about what actually came in and what actually went out.
The third difference is speed. Add two technicians or pick up a new authorization and your cost structure looks different within a month. Last quarter’s numbers stop describing your practice pretty quickly, which is why a steady monthly close matters more here than almost anywhere else in bookkeeping for therapists and other mental health practices. Seeing labor cost as a share of revenue, period by period, is what keeps growth from quietly eating your margin.
There is also the contractor side. Many ABA practices pay W-2 technicians and contract supervisors at the same time, so both have to be tracked all year and reported correctly in January.
If your practice is in this territory, I would be glad to look at where things stand. You can read more about how I work with ABA and behavioral health practices, then book a consultation with me and we will talk it through.
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.
More Questions
I'm a good therapist and my books are a disaster. How normal is that?
It is extremely normal. Clinicians spend years training for the work in the room and almost no time learning bookkeeping, so the money side is usually the part that slips. Catch-up work has a clear beginning and a clear end, and it says nothing about your skill as a clinician.
Read answerWhat kind of practice fits AD Keeps The Books best?
Mental health practices with one to about ten people, anywhere in the country. Solo therapists, psychologists, LCSWs, addiction counselors, psychiatric nurse practitioners, group practices, telehealth practices, and ABA providers. If you want your books current and a bookkeeper who already speaks your language, you're the fit.
Read answerMy practice is brand new. When should bookkeeping start?
At the beginning, ideally before your first client payment arrives. A practice that opens with a separate business account, a proper QuickBooks setup, and a monthly rhythm never needs a cleanup later, and starting right costs far less than untangling a year of mixed records.
Read answerWhy don't my SimplePractice deposits match my session income?
Your platform pays out after processing fees come off the top, and it batches those payouts on the processor's schedule rather than one per session. That means the bank will never match your session ledger on its own. Good books record the gross revenue and the fees separately so both numbers are real.
Read answerI've been running my practice through my personal checking account. How do I untangle it?
This is the most common thing practice owners tell me, and it is completely fixable. The fix has two parts, opening dedicated business accounts for everything going forward, and sorting the historical mix so the practice's real activity gets recorded properly.
Read answerHow should insurance payments show up in my books if you don't do billing?
I don't do insurance billing, claims, ERA posting, or credentialing. That work stays in your practice management system or with your biller. What bookkeeping does is reconcile what that process produces, matching every payer deposit that reaches your bank against what your records say you were paid.
Read answer
