Mental & behavioral health
Books and taxes for ABA therapy providers.
An insurance authorization for forty hours of direct service, an RBT's hourly paycheck, a BCBA's supervision billed at its own rate, and mileage for home-based sessions. Gus sorts all of it, an accountant checks every transaction, and you get one number a month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
August came in at $16,000. Two RBTs picked up extra authorized hours while school was out, so wages ran higher than usual, and I flagged why.
- Insurance authorization payoutDirect service hours
- RBT payrollRBT wages
- BCBA supervision billingSupervision hours
- Mileage reimbursementTravel and mileage
- Central Reach subscriptionPractice software
Why your books are different
An ABA provider's books go wrong around hours and staffing.
A generalist sees payroll and a deposit. Your business bills insurance for direct service hours and separate supervision hours, pays a staff of RBTs by the hour, and often reimburses mileage for home and school-based sessions. When the books flatten all of that, the labor math goes wrong.
-
1
Direct service and supervision hours get billed at different rates but booked as one
Insurance pays one rate for an RBT's direct hours with a client and a different rate for a BCBA's supervision of that case, and lumped together, the practice cannot see whether it is billing enough supervision to support its caseload.
What we doKeeps direct service revenue and supervision revenue in their own lines so the mix stays visible. -
2
RBT wages are the single biggest cost and the easiest one to lose track of
A staff of RBTs paid hourly, sometimes across multiple clients and locations in a day, can make labor cost hard to see clearly against what those hours actually billed.
What we doKeeps RBT wages in their own line against direct service revenue, so labor cost against billed hours is always visible. -
3
Authorized hours that go unused still cost the practice in scheduling
Insurance authorizes a set number of hours per client per month, but a no-show or a canceled session means those hours go unbilled while staff are still paid or scheduled for that block.
What we doBooks what was actually billed, not what was authorized, so a gap between the two is visible rather than assumed away. -
4
Mileage and drive time between home and school sessions go untracked
Providers running home-based or school-based sessions rack up real mileage between appointments, and if nobody logs it, a legitimate deduction disappears every year.
What we doKeeps mileage reimbursement and travel costs in their own line so the deduction does not get missed.
Your categories
The categories Gus keeps for an ABA therapy provider.
Set up once for how the practice gets paid and what it spends. Nobody hand-sorts a category. Gus does, and an accountant checks it.
Money in
- Direct service hoursRBT session hours billed to insurance at the authorized rate.
- Supervision hoursBCBA supervision and case management, billed and tracked apart from direct service.
- Assessment billingInitial and periodic assessments billed separately from ongoing therapy hours.
- Private pay hoursFamilies paying directly for hours insurance does not authorize or cover.
Money out
- RBT wagesHourly pay for registered behavior technicians delivering direct service.
- BCBA wagesPay for board certified behavior analysts, kept apart from RBT wages.
- Travel and mileageReimbursement for staff driving between home and school-based sessions.
- Practice softwareCentral Reach, Rethink, or similar scheduling and data collection software.
- Credentialing and licensingBCBA certification fees and state licensing where required.
- Malpractice insuranceProfessional liability coverage for clinical staff.
What we watch for you
- Labor share
RBT and BCBA wages against billed hours. It is the number that decides whether staffing is sized right.
- Supervision ratio
How much supervision revenue you bring in against direct service revenue, so the caseload stays supportable.
- Billed versus authorized hours
The gap between what insurance authorized and what actually got billed, so missed hours are visible.
- The set-aside
What the business will owe, tracked every month, so April is a number already known.
Ask Gus
Things ABA provider owners ask Gus.
Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.
Yes. Two RBTs picked up extra authorized hours while school was out, so both wages and billed hours went up together. Your margin held.
Almost always payroll. An RBT who works your schedule, your clients, and your protocols is an employee under the rules, and getting that wrong on a staff this size gets expensive fast.
About 12 percent was supervision billing this month. I keep that ratio visible every month so you can see if it is enough to support your caseload.
The tax side
The tax side of an ABA therapy practice.
Most of what goes wrong here is worker classification and labor cost visibility, since payroll is the largest expense in this trade by far.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Worker classification for RBTsAn RBT who works your schedule, sees your clients, and follows your treatment protocols is almost always an employee, not a contractor. This is the highest-stakes issue for a staffing-heavy ABA practice.
- Payroll tax obligationsOnce RBTs and BCBAs are properly classified as employees, the practice owes its share of payroll taxes and needs state unemployment insurance registration. Gus does not run payroll but keeps the books ready for whoever does.
- Mileage deductionBusiness mileage between home and school-based sessions can be deducted at 72.5 cents a mile from January through June 2026 and 76 cents a mile from July through December 2026.
- The pass-through deductionMost owners can deduct up to 20 percent of business profit before it is taxed, though this often shrinks for a personal-service business like clinical therapy at higher income.
Deductions ABA therapy providers miss
Your bookkeeper knows what to look for in your statements. You never have to.
- RBT and BCBA mileage
- Malpractice insurance premium
- BCBA certification and renewal fees
- Continuing education hours
- Central Reach or Rethink software
- Data collection tablets or devices
- Background check fees for new hires
- Clinical materials and reinforcers
- Office or clinic space rent
- Business phone line for scheduling
- Professional liability insurance
- Supervision training courses
General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.
All year, not just April
An ABA provider's year, kept every month.
Hours often rise in the summer as families add sessions during school breaks, then settle once the school year resumes. Gus keeps the practice ahead of both the calendar and the tax deadlines. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.
- January
Plan the year
Last year's return gets started, BCBA renewal dates are on the radar, and the monthly set-aside is planned.
- April
Filed. Done.
The business return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where the practice stands, what it will owe, and whether the summer hours increase changed the number.
- October
Before winter break
Gus looks at staffing and any equipment moves worth making before December, ahead of the next school break scheduling shift.
What you get
What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.
Book a call- Monthly bookkeeping
Every transaction sorted into categories set up for ABA therapy providers. You never categorize a thing.
- An accountant checks every transaction
Real review, every month, before your books close. Not a spot check.
- Your business tax return, filed
Prepared, reviewed, and signed by that same accountant every year.
- The monthly number
What you made, what you spent, what to set aside for taxes.
- Your own bookkeeper
A real person assigned to your business, in the app whenever you need them. No hold music.
- On your books all year
Every month, not just in April. Your team speaks up whenever something is worth your attention.
- Cancel any time
No contract. No cancellation call. Your books are yours.
Straight answers
Questions ABA provider owners ask first.
Can Gus separate direct service revenue from supervision revenue?
Yes. They are kept in their own lines so you can see the mix and whether your supervision billing supports your caseload.
We pay some RBTs hourly and a couple as contractors. Is that a problem?
It might be. Gus flags a contractor whose schedule and work pattern looks like an employee's, so you can get ahead of it with the accountant instead of finding out later.
Does Gus track authorized hours against billed hours?
Gus books what was actually billed from your bank and billing records. He does not manage insurance authorizations directly, but he can show you the gap between billed and authorized hours if you provide that data.
Our RBTs drive between multiple client homes each day. Can that be deducted?
Yes, usually. Business mileage between sessions is a real deduction, and Gus keeps it in its own line so it does not get missed at tax time.
Our billing swings a lot month to month. Is that normal?
It is common in this trade, especially around school breaks when families add hours. Gus flags a seasonal swing as seasonal so it does not get mistaken for a trend.
We are switching from Central Reach to a new practice software. Will that mess up our books?
No. Gus works from your bank statements and billing deposits, not the software itself, so a switch does not interrupt the bookkeeping.
Is a real accountant checking my books?
Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.
What does it cost, and can I cancel?
It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.
More in mental & behavioral health
We keep books for the business next door too.
- Neurofeedback clinics
- Psychological testing & assessment practices
- Child & adolescent therapy practices
- Sober living homes
- Couples & marriage counselors
- Eating disorder treatment programs
- Group therapy practices
- Ketamine clinics
- Psychiatry practices
- Solo private practice therapists
- TMS clinics
- Intensive outpatient programs (IOP)
- Addiction treatment centers
- Compounding pharmacies
- Durable medical equipment (DME) suppliers
- Elective 3D/4D ultrasound studios
- Independent pharmacies
- Medical billing companies
- Mobile nursing & concierge nurse services
- Mobile phlebotomy services
- Mobile x-ray & ultrasound services
- Occupational health & DOT physical clinics
- Orthotics & prosthetics providers
- Sleep clinics
- Wound care clinics
- Birth doulas
- Breathwork facilitators
- Dental labs
- Dental sleep medicine practices
- Denturists & denture clinics
What makes a bookkeeper worth paying for Every business we keep books for
Book a call
Pick a time. That's the whole signup.
Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.
- $197 a month to start
- An accountant on every transaction
- Cancel whenever