Does keeping my office make financial sense versus staying telehealth?

This question comes up a lot right now, and the good part is that most of it is arithmetic your books can already settle for you.

Start with what the office truly costs every month. Rent is the obvious piece. Then add utilities, internet, cleaning, parking, insurance on the space, furniture and decor you have replaced, the water and tea in the waiting area, and any share of your phone or software costs that exists only because you have a physical location. When all of that sits together in your books instead of being scattered across a dozen categories, the real number tends to surprise people. It is usually well above the rent check.

Next, count the sessions that actually happened in that room last month. Divide your all-in office cost by that number and you have your cost per in-person session. Hold it next to your fee for those sessions. That one figure will tell you more than any general advice ever could. Bookkeeping for therapists is mostly about making questions like this answerable instead of a guess you carry around.

Commute belongs in the math too, even though it never appears on a profit and loss statement. Forty minutes each way, three days a week, is real time out of your life, and some of it could have been a session or an evening at home. Put a number on it that feels honest to you and include it.

Then look at the other side of the ledger. What does the room let you do that video does not? Clients who will not meet online, play-based work with children, couples and family sessions, in-person groups, and referral relationships that come from being known in your area. If the revenue that exists only because you have a space covers the all-in cost with room left over, the office is paying for itself.

Plenty of practices land in the middle. Current industry reporting suggests hybrid practices often hold onto the most profit, because they reach a wider client base without carrying full-time office overhead. Day-rate suites, hourly rentals, and sharing space with another clinician all shrink the fixed cost. Those rates vary quite a bit by market, so price the options where you live before deciding.

To compare cleanly, your books need a little structure. I group office costs so they roll up together and set revenue up so in-person and virtual work can be seen separately when your practice management system supports it. Three to six months of that inside full-service bookkeeping and the answer shows up in your monthly reports. Anything about home office deductions belongs with your tax preparer, and I keep the records they need.

I can hand you the numbers. What kind of practice you want to run stays your call, and it should. If you would like help getting to that cost-per-session figure, book a consultation with me and we will work it out together.