Mental & behavioral health
Books and taxes for child and adolescent therapy practices.
A parent's copay for their kid's weekly session, a school consultation billed separately from the therapy hour, a sandtray and puppet restock, and a September rush of new intakes. 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
September came in at $14,300. New intakes jumped after school started, so I flagged it as a seasonal bump, not your new normal.
- Cigna copaysClient copays
- Private pay sessionsPrivate pay sessions
- School consult feeConsultation fees
- Play therapy supplies orderClinical materials
- TherapyNotesPractice software
Why your books are different
A child therapy practice's books go wrong around parents, schools, and supplies.
A generalist sees a deposit and a supply bill. Your practice bills a parent's insurance for a child's session, charges separately for a school consultation or a parent-only check-in, and restocks play therapy materials that wear out fast. When the books flatten all of that, the month reads wrong.
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1
School consultations get billed like a therapy session or not billed at all
A call or meeting with a child's teacher or school counselor is real clinical work, but it often falls outside what insurance will cover for the session itself, and many practices either skip charging for it or bury it inside a regular session fee.
What we doKeeps consultation fees in their own line so you can see what that work brings in against the time it takes. -
2
Parent-only sessions blur into the child's treatment
A session with just the parents, common in family and child work, is billed differently than a session with the child present, and mixed together the practice cannot tell which type of session is actually filling the calendar.
What we doKeeps parent sessions and child sessions in separate lines so the mix is visible, not guessed at. -
3
Play therapy materials wear out and get restocked in bulk
Sandtray figures, puppets, and art supplies used every day wear out fast, and one large restock order can make a slow month look like a loss when it is really just a supply run.
What we doKeeps clinical materials in one steady line and flags when a big restock, not a slow month, is the reason the number looks thin. -
4
The fall intake rush gets mistaken for a permanent jump
New client intakes often spike hard once school starts, and an owner who reads that as the new normal can overcommit to added hours or staff before winter shows the real average.
What we doFlags a seasonal jump as seasonal, so a strong September does not drive a decision that a full year does not support.
Your categories
The categories Gus keeps for a child therapy practice.
Set up once for how you get paid and what you spend. You never pick a category. He does, and an accountant checks it.
Money in
- Client copaysParent copays collected at time of service, through your card reader or client portal.
- Private pay sessionsFamilies paying full fee by card, ACH, or check.
- Consultation feesSchool meetings and teacher calls, billed apart from therapy sessions.
- Parent sessionsSessions with parents only, tracked separately from child sessions.
Money out
- Clinical materialsSandtray figures, puppets, art supplies, and games that wear out and get replaced.
- Practice softwareTherapyNotes, SimplePractice, or similar scheduling and notes software.
- Malpractice insuranceYour professional liability premium.
- Continuing educationPlay therapy and child-specific training and certifications.
- Office rentA space set up for play therapy, often with extra furnishings.
- Testing or screening toolsStandardized screeners used in intake or ongoing assessment.
What we watch for you
- Consultation revenue
What school and parent consultations bring in, separate from regular sessions, so that work is not invisible.
- Seasonal intake swing
How much intakes jump in the fall against the rest of the year, so a strong month is read correctly.
- Materials cost per client
Clinical supplies against active caseload, so a restock does not read as a loss.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things child therapy practice 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.
No. Your sessions still came in ahead. I kept the restock in its own line so you can see it was a one-time purchase, not a slow month.
That is a rate and policy decision for you to make. Once you do, I will track it in its own line so you can see what it brings in.
Probably not at that pace. New intakes usually spike when school starts, then settle. I will keep watching your average so a decision to hire or expand is based on the year, not one month.
The tax side
The tax side of a child therapy practice.
Most of what goes wrong here is timing and labels: a restock mistaken for a loss, a seasonal spike mistaken for the new normal, and a self-employment tax bill set aside too late.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Self-employment taxA solo practitioner taking profit directly owes 15.3 percent self-employment tax on top of income tax, up to the Social Security wage base of $184,500.
- The pass-through deductionYou can often deduct up to 20 percent of your practice's profit before it is taxed, though this can shrink at higher income for a personal-service business like therapy.
- Contractor 1099sA billing service, supervisor, or contractor clinician paid $2,000 or more in 2026 who is not on payroll gets a 1099-NEC by January 31.
- Equipment and materialsLarger purchases like a sandtray cabinet or dedicated play therapy furniture can usually be written off in the year bought, separate from routine supply restocks.
Deductions child and adolescent therapy practices miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Sandtray figures and puppets
- Art and craft supplies
- Standardized screening tools
- Malpractice insurance premium
- Play therapy certification courses
- TherapyNotes subscription
- License renewal fees
- Office rent for a play-friendly space
- Waiting room toys and books
- Continuing education and conferences
- Background check fees for new hires
- Business phone line
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
A child therapy practice year, kept every month.
Intakes surge every September as school starts and slow in the summer. Your taxes stay on a schedule the whole way through. Your team keeps you ahead of both. 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, and the monthly set-aside is planned around your seasonal swing.
- April
Filed. Done.
Your return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where you stand before the fall rush, and whether the summer slowdown changed what you will owe.
- October
After the rush
Gus looks at whether September's surge held or settled, and any equipment or hiring moves worth making before December.
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 child and adolescent therapy practices. 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 child therapy practice owners ask first.
Can Gus separate what I earn from parent-only sessions?
Yes. Parent sessions are kept in their own line, separate from sessions with the child present, so you can see the mix.
I do unpaid school consultations sometimes. Does that matter for the books?
Unpaid time is not entered as revenue, but if you decide to start charging for it, Gus tracks that income the moment it starts landing in your account.
My supply orders are irregular. Will that confuse the books?
No. Gus keeps clinical materials in one steady category and flags a big order as a stock-up, not a bad month, so the pattern makes sense.
Does Gus submit claims to my clients' insurance for me?
No. Gus books the copay or reimbursement once it lands in your account. Submitting claims and any coding work stays with your practice software or biller.
My intake numbers swing a lot between September and July. Is that a problem?
It is normal for this kind of practice. Gus tracks the swing so a slow summer does not get mistaken for a real decline, and a busy fall does not get overbuilt on.
My books have never separated consultation fees from session fees. Can that be fixed?
Yes. Once Gus has your past session and consultation records, he can sort earlier months the same way and keep the two apart from here on.
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.
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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