What is a healthy overhead percentage for a practice?
The figure quoted most often for a lean solo practice is overhead under about 32 percent of revenue. Group practices normally run higher, sometimes quite a bit higher, once associate clinicians and administrative help are on the books. Treat those numbers as current guidance worth verifying, because published benchmarks shift and different sources draw the line in different places.
The math itself is simple. Add up what the practice spent on operating costs for the month and divide that by the revenue that came in during the same month, then multiply by 100. Overhead for most mental health practices covers rent, your EHR or practice management subscription, professional liability insurance, phone and internet, website and scheduling tools, merchant processing fees, continuing education, license renewals, and any administrative support.
The choice that decides whether your percentage means anything is where clinician pay goes. In a solo practice, what you pay yourself usually sits outside overhead, since it is the return on your clinical hours. In a group practice, associate compensation is commonly treated as the cost of delivering care, though plenty of owners fold it into overhead instead. Either approach works fine as long as you pick one and stay with it. A month that includes associate pay compared against a month that leaves it out will tell you nothing useful.
Here is where a benchmark stops helping. It cannot see your lease. A counselor paying for a suite in an expensive market and a telehealth practice run from a spare bedroom can both be perfectly healthy at very different percentages. The same goes for a psychologist buying testing materials or an ABA practice carrying a staff-heavy team. Bookkeeping for mental health professionals gets useful right at this point, because your own number tracked over time says more than any published average.
Look at the trend across several months rather than one snapshot. An annual insurance premium, a conference, or a new laptop all land in a single month and make that month look rough. Three, six, and twelve month views smooth that out and show whether your percentage is genuinely climbing. If it is rising while revenue holds steady, that is your cue to go through the subscription stack and see what nobody remembers signing up for.
Most practice owners have never seen this number at all. There is rarely time to build it by hand between sessions. When transactions are categorized consistently and accounts are reconciled every month, the percentage falls right out of the profit and loss statement without anyone doing extra work. That is a big part of what full-service bookkeeping is meant to give you.
If you would like to know what your own overhead percentage is and what it has been doing over the past year, book a consultation with Aretha and she will walk through the numbers with you.
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More Questions
How do no-shows and late cancellations show up in my numbers?
Mostly they show up as an absence, which is why they are so easy to miss. Cancellation fees you actually charge should sit in their own income category so you can see what you recovered, and the cost of the empty slots shows up as the gap between what was scheduled and what was earned.
Read answerWhat does my software stack really cost me per month?
Most practices are surprised by the total once every subscription is added up, since EHR tiers, telehealth add-ons, scheduling tools, directory listings, and card processing fees all arrive separately. Coding them to one category in your books gives you a single number you can review and prune once a year.
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 answerHow should associate compensation splits be recorded in a group practice's books?
Record the full amount collected as practice revenue and the clinician's share as a compensation expense, never netted together. Track collections by clinician so the split is calculated from a number both sides can see, and apply the written agreement exactly as it reads.
Read answerPrivate-pay and insurance money arrive on completely different rhythms. How do the books keep that straight?
Card payments usually land in a couple of business days while insurance remittances take weeks, so any month's deposits are a mix of recent sessions and older claims. Clean books date revenue consistently, separate the payer streams, and break lump deposits back into their pieces so you can tell a slow payment week from a slow month of work.
Read answerHow do I know if my group practice actually makes money on each clinician?
Take what each clinician actually collected, subtract everything you pay them, then subtract a fair share of overhead. What is left is what that seat contributes. Run it person by person, because a practice-wide margin can look fine while one seat quietly loses money.
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