Mental & behavioral health
Books and taxes for solo private practice therapists.
An Alma payout for eleven clients, an Ivy Pay copay, a private-pay card charge, and a sliding-scale client who pays less some months. 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
February came in at $10,100. Your Aetna batch was smaller than January's, so I checked it against your session log before booking it as income.
- Alma payoutInsurance sessions
- Ivy Pay copaysClient copays
- Private pay, cardPrivate pay sessions
- SimplePracticePractice software
- Clinical supervision feeSupervision
Why your books are different
A solo practice's books go wrong in the same handful of places.
A generalist bookkeeper sees deposits and a subscription bill. Your practice is an insurance batch that lags the session by weeks, a copay charged the same day, and a self-employment tax bill nobody set aside for. When the books do not know the difference, the monthly number lies to you.
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1
The insurance batch never matches the calendar
An Aetna deposit for eighteen sessions across eleven clients lands three weeks after you saw them, already reduced by the plan's contracted rate. Booked as one lump sum with no session count behind it, you cannot tell whether January or February actually paid better.
What we doBooks the deposit as income the day it lands and notes the payer and rough session count, so you can see collections against sessions instead of guessing. -
2
Sliding-scale sessions look like a bad month
A client you see at a reduced rate during a hard stretch, or a waived no-show fee, quietly lowers a month's revenue with nothing written down to explain why.
What we doBooks what you actually collected and keeps a plain note when a rate was adjusted, so a lighter month reads as a choice, not a mystery. -
3
Self-employment tax gets forgotten until April
Taking profit directly instead of a payroll paycheck means you owe self-employment tax on top of income tax, and most solo therapists do not find that out until they see April's bill.
What we doSets aside a running percentage of what you make every month, so the tax bill is never a surprise. -
4
CAQH and license renewals get lost in general expenses
Credentialing maintenance fees and your state license renewal are real, recurring costs, but buried inside a catch-all expense line they never show up as the cost of staying in-network.
What we doKeeps licensing and credentialing fees in their own line so you can see what staying credentialed actually costs each year.
Your categories
The categories Gus keeps for a solo 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
- Insurance sessionsPayouts from Aetna, Cigna, or a network like Alma or Headway, tied to the sessions behind them.
- Client copaysSame-day charges through Ivy Pay or the card reader in your scheduling software.
- Private pay sessionsOut-of-network clients paying full fee by card, ACH, or check.
- Sliding-scale adjustmentsSessions billed at a reduced rate, kept visible instead of hidden inside private pay.
Money out
- Practice softwareSimplePractice, TherapyNotes, or TheraNest subscription fees.
- SupervisionClinical supervision fees if you are working toward full licensure.
- Licensing and CAQHState license renewal and insurance credentialing maintenance.
- Malpractice insuranceYour professional liability premium.
- Continuing educationCourses and conferences required to keep your license current.
- Office rentA single office or a room inside a shared suite.
What we watch for you
- Collection rate
What you actually collect against what you billed. It shows the real size of your practice.
- Insurance lag
How many weeks pass between a session and its deposit, so a slow month reads correctly.
- Private-pay share
How much of the month is private pay versus insurance, so you know your exposure to a slow payer.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things solo therapists 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 checked it against your calendar. It covers fourteen sessions at the contracted rate, not eighteen, so two must still be pending. I noted it and will flag it again if it does not show up next month.
Yes. I have been setting aside about 20 percent of what you make each month, so the self-employment tax and income tax bill in April is not a surprise.
That is a real question with a real answer, but it depends on your whole year and the March 15 election deadline. I flagged it for the accountant to walk through with you.
The tax side
The tax side of a solo therapy practice.
Most of what goes wrong here is timing and labels: a set-aside that starts too late, a supervision fee filed as a generic expense, and a self-employment tax bill nobody planned for.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- Self-employment taxTaking profit directly instead of a payroll paycheck means you owe 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 as a personal-service business this can shrink at higher income. It comes out right when the books are right all year.
- S corp election timingOnce profit is steady, some solo therapists save on self-employment tax by electing S corp status, but the election for the current year is due March 15. Gus flags it early enough to decide.
- Contractor paymentsA biller, supervisor, or virtual assistant you pay $2,000 or more in 2026 who is not on payroll gets a 1099-NEC by January 31. Gus keeps that list as the year goes.
Deductions solo private practice therapists miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Malpractice insurance premium
- License renewal fees
- Clinical supervision fees
- Continuing education courses
- Professional association dues
- SimplePractice or EHR subscription
- Telehealth video service fee
- CAQH credentialing fees
- Office or suite rent
- Waiting room furnishings
- Business phone line
- Directory or profile 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 solo therapy year, kept every month.
Client volume dips in January when deductibles reset and picks back up by spring. 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, your license renewal dates are on the radar, and your monthly set-aside is planned so April is already handled.
- 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, what you will owe, and whether the January deductible slowdown changed the number.
- October
Before the reset
Gus looks at any equipment or software moves worth making, and whether an S corp election makes sense, before the January deductible reset slows things down again.
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 solo private practice therapists. 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 solo therapists ask first.
Can Gus tell which insurance batch belongs to which client?
He books the deposit against your session records so you can see the payer and rough session count behind it. He does not submit or track individual claims; that stays with your biller or clearinghouse.
I use Alma for some clients and bill insurance directly for others. Is that a problem?
No. Gus works from whatever lands in your bank account, whether it is an Alma payout, a direct insurance deposit, or a private-pay charge, and sorts each one correctly.
Do I need to set anything up before I start?
No. Send your bank and practice software statements when Gus asks and he takes it from there. Nothing changes about how you run sessions or bill clients.
My books are eight months behind. Can Gus catch up?
Yes. Send what you have and he sorts it month by month. Most solo therapists know exactly where they stand within a week or two.
Does the subscription include filing my personal return?
No. It covers your practice's bookkeeping and business tax return. Your personal return is handled separately, though Gus keeps the numbers ready for whoever prepares it.
Can Gus tell me if I should become an S corp?
He will flag it as worth discussing once your profit looks steady, and the accountant walks through the real numbers with you before the March 15 deadline.
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