Do I need an accountant, a bookkeeper, or both?
Most private practices end up working with both, and that catches people off guard when they assumed one person handled everything money related.
Here is the plain version of the split. A bookkeeper keeps your financial records accurate and current all year long. That means categorizing transactions, reconciling your bank and credit card accounts against the statements, matching deposits from your practice management system to what actually landed in the bank, tracking what you pay associates and contractors, and handing you monthly reports you can read in a few minutes between sessions.
A tax professional, usually a CPA or an enrolled agent, takes those records and prepares your returns. They also answer the questions that carry real dollars. Whether an S corporation election makes sense for your practice, how much to set aside for quarterly estimates, how your home office or mileage should be treated, and what the current rules and thresholds look like for the year you are filing. Those numbers and rules shift from year to year, so they should always come from the person who signs your return.
The two roles feed each other, which is the part people miss. A tax preparer can only work with what they are handed. When they get a year of uncategorized transactions, they either bill you for cleanup at their hourly rate or they estimate, and neither one leaves you better off. Clean, reconciled books make tax season cheaper and a lot calmer. Bookkeeping for mental health professionals is the year-round half of that pair, and it is the half Aretha handles.
Could you get by with just one for a while? Sometimes, yes. A brand new solo practice with a handful of clients, one business checking account, and no payroll can often manage its own records for a season and hire a tax preparer in the spring. The point where that stops working is usually predictable. You bring on your first associate, you add a second income stream like assessments or supervision, you fall a few months behind, or you start avoiding the bank app.
Aretha does not prepare tax returns. She keeps full-service bookkeeping current from $165 a month so your books are tax-ready and your tax preparer has everything they ask for without a scramble. If you already have someone doing your taxes, she works alongside them. If you do not have one yet, getting your books clean first makes that search a whole lot easier.
If you want to talk through which half of that pair your practice is missing, book a consultation with Aretha and she will tell you honestly.
Helping the People Who Help Others
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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
What's different about bookkeeping for a psychologist who does testing?
Testing behaves like a second business inside the same practice. The engagements run long, the money often arrives on a different schedule than the work, and materials cost real money, so testing revenue and testing costs belong in their own categories.
Read answerHow much does bookkeeping cost for a private practice?
Full-service monthly bookkeeping for a private practice starts at $165 a month. Add-ons like payroll processing, bill payment, invoicing, and 1099s each have their own starting price, and catch-up or clean-up work gets quoted once I see what you have.
Read answerWhat has to happen before January so contractor 1099s are easy?
Almost everything. Collect a W-9 from every contractor before the first payment, record payments by payee all year long, and review the totals in December. Do that and January is nothing more than paperwork.
Read answerWhat makes ABA practice books harder than a therapy practice's?
It comes down to people, volume, and speed. An ABA practice runs a team of technicians and analysts, so real payroll happens every period, high session volume means revenue arrives as remittances that have to reconcile against the work delivered, and the numbers change fast when the practice grows.
Read answerI'm leaving agency work to start a private practice. What financial setup do I actually need?
You need less than you think. A business bank account, a QuickBooks file set up for a practice instead of a generic business, a simple monthly rhythm starting your first month, and records your tax preparer will want at year end.
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 answer
