My practice is brand new. When should bookkeeping start?
Right at the beginning. If you can manage it, before the first client payment lands.
I know that sounds like a bookkeeper talking, so here is the honest reason. Nearly every cleanup I take on started as a brand new practice where nobody set anything up. Eight months of deposits went into a personal checking account. The office furniture and the family groceries are on the same credit card. There is a payment app with a balance nobody has looked at since spring. None of that happens because someone was careless. It happens because a clinician was busy building a caseload, which is exactly what they should have been doing.
Starting is smaller than most people expect. Open a business checking account and a business card in the practice’s name, and run everything through them from the first dollar. Get your bookkeeping software configured with a chart of accounts that actually reflects how a mental health practice earns and spends. Then settle into a monthly rhythm so a stack never forms.
For a new practice, the natural first step is QuickBooks Online setup and training. I am a QuickBooks ProAdvisor, and I set the file up the way a therapy, testing, or prescribing practice needs it, then walk you through using it so you are not guessing in month two. That is a one time piece of work, and it saves you from the generic template that categorizes your EHR subscription and your liability insurance into a bin called Other.
You do not have to buy everything at once. Plenty of practices start with the setup, keep things tidy themselves for a few months, and move to monthly service once the caseload fills in. Monthly bookkeeping with me starts at $165, and a catch-up or clean-up engagement almost always costs more than the months of steady work would have. Private practice bookkeeping is one of the few expenses where paying early is cheaper than paying late. Pricing does change over time, so confirm current rates with me when we talk.
There is a tax reason too. Your very first year sets the baseline your tax preparer works from, including startup costs, equipment, and any home office records. Clean books from month one mean your preparer gets what they need without reconstructing anything, and the questions about amounts owed and strategy go to them with real numbers behind them.
If you are opening now or you opened a few months ago and want to get on solid footing, book a consultation with me and we will figure out the right starting point together.
Helping the People Who Help Others
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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
Which parts of my practice make the most money?
You can only answer this if your books split revenue by service line and you know roughly how many hours each line takes. Individual sessions, couples work, groups, testing, supervision, and workshops all earn differently per hour of your time once direct costs come out.
Read answerWhy does it matter that my bookkeeper knows mental health?
It saves you from explaining your own practice before you can ask a question, and it keeps your books categorized in the language of a practice rather than a generic business. After more than 15 years as a nurse in mental health, the learning curve happened long before my first bookkeeping client.
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 answerI'm a good therapist and my books are a disaster. How normal is that?
It is extremely normal. Clinicians spend years training for the work in the room and almost no time learning bookkeeping, so the money side is usually the part that slips. Catch-up work has a clear beginning and a clear end, and it says nothing about your skill as a clinician.
Read answerWhere do my payment processing fees actually go in my books?
Processing fees belong in their own expense account, with your session revenue recorded at the full amount clients paid. If you only record the smaller net deposit that lands in your bank, both your revenue and your fees disappear from view.
Read answerWhat'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.
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