Mental & behavioral health
Books and taxes for group therapy practices.
A Headway payout covering nine clinicians, an associate's split going back out, a DBT skills group billed at its own rate, and rent for a multi-room suite. 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
May came in at $15,000. Two new associates' splits are booked as their own line now, so you can see your cut instead of the whole practice's collections.
- Headway payoutInsurance sessions
- Client card paymentsPrivate pay sessions
- Associate clinician splitClinician pay
- TherapyNotesPractice software
- Suite rent, four roomsOffice rent
Why your books are different
A group practice's books go wrong where the money changes hands twice.
A generalist sees one deposit and one payroll run. Your practice collects the full fee, pays a clinician their split, bills individual and group sessions at different rates, and covers a multi-room suite. When the books do not separate all of that, you cannot tell what the practice actually keeps.
-
1
Clinician splits look like practice profit
When the practice collects the full session fee and pays an associate 60 percent of it, booking only the deposit makes the practice look like it keeps money that is already spoken for the moment it lands.
What we doBooks the full collection as income and each associate's split as its own cost, so the owner sees the practice's real cut, not the gross number. -
2
Group session billing gets buried inside individual sessions
A DBT skills group or a process group is often billed to insurance at a different rate than an individual session, and mixed together the owner cannot tell whether group programming is actually worth running.
What we doKeeps group session revenue in its own line so the owner can see it against what those sessions cost in facilitator time. -
3
1099 clinicians who work like employees
An associate who works set hours in the practice's suite, uses its scheduling software, and sees only the practice's clients looks like an employee to the IRS, no matter what the split arrangement is called.
What we doKeeps 1099 and W-2 pay in separate lines and flags a contractor whose pattern looks like an employee's, so the owner gets ahead of it. -
4
A multi-room suite blurs into one rent line
A practice renting four or five rooms for different clinicians often pays one lump rent bill, which makes it hard to know what it actually costs to add another clinician to the space.
What we doKeeps rent as its own steady line and flags when a new hire changes what the space actually costs per clinician. -
5
Supervision fees for associates get lost in general costs
A practice paying an outside or in-house supervisor for its associate-level clinicians often files that cost the same as any other bill, which hides what it actually costs to train someone toward full licensure.
What we doKeeps supervision fees in their own line so the owner sees what it costs to bring an associate to full licensure.
Your categories
The categories Gus keeps for a group therapy practice.
Set up once for how the practice gets paid and what it spends. Nobody picks a category by hand. Gus does, and an accountant checks it.
Money in
- Insurance sessionsPayouts from Aetna, Cigna, or a network like Headway, covering every clinician's individual sessions.
- Group session billingDBT skills groups and process groups, billed and tracked apart from individual sessions.
- Private pay sessionsOut-of-network clients paying by card, ACH, or check.
- EAP contract sessionsFlat-rate sessions from an employee assistance program administrator.
Money out
- Clinician payW-2 wages for employed clinicians and 1099 splits for associates, kept apart.
- Clinical supervisionFees paid to supervise associates working toward full licensure.
- Office rentThe multi-room suite or clinic space.
- Practice softwareTherapyNotes, SimplePractice, or TheraNest, and any add-on telehealth fee.
- Credentialing and licensingCAQH maintenance and each clinician's state license renewal.
- Malpractice insuranceCoverage for every clinician on staff.
What we watch for you
- Clinician pay share
Wages and splits against total collections. It shows what the practice keeps per clinician.
- Group session share
How much revenue comes from groups versus individual sessions, so you know if group programming pays for itself.
- Insurance lag
How many weeks pass between sessions and a batch deposit, so a slow month reads correctly.
- The set-aside
What the practice will owe, tracked every month, so April is a number already known.
Ask Gus
Things group 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.
I book the batch as one deposit but keep a running note of the sessions inside it by clinician, so you can spot a slow month before it becomes a pattern.
That is worth a real look. If they work set hours in your suite on your schedule, they usually should be. I flagged it for the accountant to walk through with you.
I keep group revenue separate from individual sessions, so you can see that number clearly. What to do about it is a call only you and your team can make.
The tax side
The tax side of a group therapy practice.
Most of what goes wrong here is worker classification and timing: an associate paid like a contractor who works like an employee, and a set-aside that starts too late for a practice with real profit.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Associate worker classificationAn associate who works set hours in your suite, on your schedule, using your software, is usually an employee, not a contractor. Getting this wrong on multiple clinicians gets expensive fast.
- Contractor 1099sAny supervisor, biller, or contractor clinician paid $2,000 or more in 2026 who is not on payroll gets a 1099-NEC by January 31. Gus keeps that list all year.
- The pass-through deductionMost practice owners can deduct up to 20 percent of business profit before it is taxed, though this often shrinks for a personal-service business like therapy at higher income levels.
- Payroll tax obligationsOnce clinicians 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.
Deductions group therapy practices miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Malpractice insurance for the practice
- Clinical supervision fees
- License renewal for each clinician
- Continuing education for staff
- Suite or office rent
- TherapyNotes or EHR subscription
- Telehealth software fee
- CAQH credentialing fees
- Group therapy materials and worksheets
- Background check fees for new clinicians
- Waiting room and group room furnishings
- Directory or referral listing fees
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 group practice year, kept every month.
Session volume dips in January as deductibles reset across every clinician's caseload, then steadies through the year. 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, the 1099 list for any contractor clinicians is ready, 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 adding a new clinician this spring changed the number.
- October
Before recredentialing
CAQH recredentialing and EAP contract renewals often land in the fall. Gus looks at what to do before December alongside those.
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 group 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 group practice owners ask first.
Can Gus track each clinician's collections separately?
He books each deposit against your session records so you can see collections by clinician, not just one lump total for the practice.
We pay associates a percentage split. Does Gus handle that?
He books the full collection as income and each associate's split as its own cost, so you see the practice's real cut. He does not calculate or send the split payment itself.
Do you help us decide if an associate should be W-2 instead of 1099?
Gus flags a pattern that looks like an employee, and the accountant walks through the real classification with you. The final call and the payroll setup stay with you.
Our group sessions bill at a lower insurance rate than individual sessions. Can the books show that?
Yes. Group session revenue is kept in its own line, separate from individual sessions, so you can see what it actually brings in against the time it takes.
We just added a fourth room to our suite. Does that change anything?
Gus flags the new rent cost and tracks it against your growing clinician count, so you can see what the added space actually costs per clinician.
Does Gus submit our insurance claims for each clinician?
No. Gus books whatever an insurance batch pays out once it lands in your account. Submitting claims, prior authorizations, and coding stay with your billing service or clearinghouse.
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
- ABA therapy providers
- Couples & marriage counselors
- Eating disorder treatment programs
- 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