Which parts of my practice make the most money?
Most practice owners I talk with have a hunch about this and no numbers behind it. That is understandable, because deposits usually land in the bank as one lump from the practice management system, and one lump cannot tell you whether your Thursday group earns more than your Thursday intakes. To answer the question honestly, you need revenue separated by service line and a rough sense of how many of your hours each line eats.
Start by writing down what you actually sell. For most practices that list looks like individual sessions, couples work, groups, testing and assessment, clinical supervision, workshops or trainings, and sometimes consulting or evaluation work. Each of those carries its own fee and its own time cost, and the fee by itself is a poor guide.
The useful comparison is what each line brings in per hour of your time. A couples session may bill higher than an individual hour while taking the same 50 minutes. A group of six at a lower per-person fee can produce more in one hour than any single session, once you count the setup and follow-up time. A testing package often looks wonderful on the invoice until you add the scoring and report writing hours nobody bills for. Supervision usually takes little prep. Workshops carry hours of preparation and promotion before anyone pays a dime.
Then take out the direct costs that belong to each line. Testing protocols and forms, room rental for a group, materials and platform fees for a workshop, an associate’s split on the sessions they cover. What is left is what that line really contributes.
Setting this up in the books is not complicated. In QuickBooks Online I use separate income accounts or service items for each line, then split each deposit using the revenue detail report from the practice management system. Pair that with a rough hour count from your calendar and you have the whole picture. This is part of what I build into full-service bookkeeping, and after three to six months the patterns are usually obvious.
It is worth watching collections and attendance by line too. Group revenue can sag when attendance drifts. Assessment payments sometimes sit until the report goes out. Sliding scale often clusters in one part of the practice without the owner realizing how much.
None of this tells you what to put on your schedule. That decision is yours and it is clinical as much as financial. Some work stays because it matters to you or to the people you serve, and keeping it with your eyes open is a good way to run a practice. Bookkeeping for mental health professionals should give you the facts and leave the choices where they belong.
If you would like to see where your hours are earning best, book a consultation with me and we will look at it together.
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More Questions
Can you run payroll for my group practice?
Yes, as long as your payroll system is already up and running. Aretha processes payroll every pay period and makes sure it posts correctly in your books. She does not handle initial payroll system setup, so a brand new practice would establish that first with its provider.
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Once you are paying other clinicians, the books have to answer new questions. Payroll or contractor payments begin, revenue needs to be traceable to each clinician, shared overhead has to be spread across the team, and your own pay becomes a deliberate line instead of whatever is left over.
Read answerHow do I know if my session fee is too low?
Private-pay fees commonly run around $100 to $200, with specialty work higher, but that range is only context. Your real answer comes from what your practice costs, what you need to take home, and how many sessions you can sustain. Clean books make that arithmetic honest.
Read answerDo I need an accountant, a bookkeeper, or both?
Most private practices end up with both. A bookkeeper keeps your records accurate and current all year, and a tax professional uses those records to prepare returns and advise on tax strategy. The two roles work best together.
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 answerWhat does monthly bookkeeping actually do for a private practice?
Monthly bookkeeping keeps your books current, keeps your financials tax-ready, and gives you a clear view of how the practice is doing. Each month transactions get categorized, accounts get reconciled to the bank, and you get a short set of reports you can read between sessions.
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