How much does bookkeeping cost for a private practice?
Full-service monthly bookkeeping for a private practice starts at $165 a month. That covers your transactions categorized, your bank and credit card accounts reconciled every month, and monthly reports that show what the practice actually earned and what it spent. For most solo practices, that starting number is the number.
From there you add only what you actually need. Payroll processing starts at $150 a month for practices whose payroll system is already up and running. Bill payment starts at $85 a month, and invoicing starts at $85 a month. Year-end 1099s start at $100, which includes five forms, with $10 for each additional form. QuickBooks Online setup and training is a one-time project starting at $400, and I do that work myself as a QuickBooks ProAdvisor.
Catch-up and clean-up work gets quoted per engagement. I would not feel right putting a number on that until I see what exists, because a practice with four months untouched is a very different job than one with three years of DIY entries and accounts that have never been reconciled. So I look first, tell you honestly what I find, and give you one price before any work begins. And whatever shape your books are in, I have seen worse and I am not here to make you feel bad about it.
What moves the monthly number is volume and moving parts. A solo therapist with one business checking account, one business card, and a single payment processor sits at the low end. A group practice with several associates, multiple cards, payroll, and money arriving from different places takes more hours, so it prices higher. The same goes for practices carrying a long list of software subscriptions or a mixed schedule of therapy, testing, and consulting.
Here is how I would ask you to think about the cost. At typical session rates around the country, bookkeeping for therapists and other private practice owners runs less than two sessions a month. For that you get books that stay current, records your tax preparer can work from without an April scramble, and an honest monthly picture of what your practice is really making.
A few things the price does not include, so there are no surprises. I do not prepare tax returns. I keep your books tax-ready and your tax preparer takes it from there, and questions about what you will owe or how to plan for it belong with that professional. I run payroll where a payroll system is already set up, and I do not build the system itself. I also do not handle insurance billing, claims, credentialing, or coding.
Prices and rates shift over time, so treat these as current starting points and let me confirm your number in writing. If you want to know what your practice would actually cost, book a consultation with me. We will talk through what you have and what you need, and I will quote you plainly.
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
Does keeping my office make financial sense versus staying telehealth?
This is arithmetic your books can settle. Add up the true all-in monthly cost of the office, divide it by the sessions you actually held in that room, and compare that to what the in-person work brings in.
Read answerHow 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 should an addiction counseling practice's books account for?
Separate income by the kind of work behind it, since individual sessions, groups, assessments, and education programs earn very differently for the time and space they use. Your books also need a consistent way to record sliding scale fees, payment plans, and partial payments, plus clear tracking of group revenue and unpaid balances.
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 answerWhy would a psychiatric nurse practitioner choose a bookkeeper who used to be a nurse?
The bookkeeping itself should be excellent no matter who you hire. What my 15 years as a licensed nurse in mental health changes is how much you have to explain before the work can start. I already know the tempo of a prescribing practice and the language you use.
Read answerWhat financial records should a private practice actually keep?
Business bank and card statements, revenue reports from your practice management system, receipts for deductible expenses, payroll and contractor records, and the bookkeeping file that ties them together. Keep them organized by year and month so any question has a findable answer.
Read answer
