Practice Calc

Private Practice Overhead Calculator

Built for therapists, not dentists or chiropractors. Work through the five groups below; your numbers update as you type and nothing you enter is stored.

1Practice & caseload

Who you are and how much you work. This sets the revenue side of the comparison.

Rent default is adjusted to your state's average. Your metro may differ.

What you actually collect per session, averaged across private pay and insurance.

20 sessions
47 weeks

Subtract vacation, holidays, and sick time.

13%

Share of scheduled sessions that don't happen and aren't paid.

2Office & tech

Space, EHR, and the HIPAA-compliant tools you pay for every month.
/ month
/ month
/ month

Video, e-fax, e-signature, secure email — everything outside your EHR.

/ month

3Insurance & compliance

Coverage, licensure, and continuing education. Annual costs are spread across twelve months.
/ month
/ month
/ year
/ year

The annual AMA code-set license, usually passed through by your EHR or clearinghouse.

4Billing & payment

Costs that rise and fall with what you collect.
6.0%

Percent of collections charged by your biller.

3.0%

Percent of collections.

5.0%

Percent of what you bill that you never collect.

5Marketing & growth

What you spend to stay visible and keep referrals coming.
/ month
/ month
/ month

Your overhead

Monthly overhead
$1,806
Annual overhead
$21,666
Overhead as % of revenue
21%
Break-even sessions per week
3
Break-even sessions per month
10
Overhead per billable hour
$26

How you compare

LeanBelow the 25–40% planning range. Check that no cost is missing.

Overhead by category

Break-even point

Where it goes

ItemMonthlyAnnual
Fixed costs
Rent$757$9,084
EHR / practice management$69$828
HIPAA-compliant tech$37$444
Phone / answering service$24$288
Malpractice insurance$48$579
Cyber / business insurance$62$749
License fees and CEUs$20$240
Billing code license$2$20
Directory listings$30$359
Ads, SEO, and website$69$828
Networking and referrals$18$216
Costs that scale with revenue
Billing service$0$0
Card processing$242$2,910
Bad debt and write-offs$427$5,121

Where to look first

  1. No-shows are costing you real money

    Your no-show rate is above 10%. Each missed session is an hour you held open and weren't paid for; your break-even already accounts for the rate you entered.

    • Send automated reminders a day or two before each session.
    • Adopt a written late-cancellation policy and apply it consistently.
    • Keep a short waitlist so a cancelled hour can be offered to someone else.

  2. You're running lean

    Your overhead is below the 25%–40% planning range. That can mean a genuinely efficient practice, or a cost that is missing from these inputs.

    • Check that every recurring cost is entered, including annual fees spread across the year.
    • Confirm that your fee and caseload reflect what you actually collect, not your full rate.
    • If the numbers hold, decide in advance what the margin is for, such as a cash reserve or planned time off.

Looking for ways to grow revenue instead of trimming costs? See whether practicing across state lines pays off. Open the PSYPACT ROI Calculator

How we calculate

Revenue comes first. We take the sessions you schedule each week, keep the share that actually happen (100% minus your no-show rate), multiply by the weeks you work, and divide by 12. That is your attended sessions per month; times your average fee, it is your expected monthly revenue.

Fixed costs are the eleven items under Office & tech, Insurance & compliance, and Marketing & growth. Anything you enter per year, such as license fees and CEUs, is divided by 12. The billing code license only counts if you bill insurance.

Three costs scale with revenue. Bad debt is a share of what you bill. Card processing and an outside billing service are shares of what you then actually collect. If you handle billing in-house, no billing-service percentage is applied.

Break-even is the number of sessions whose fees cover your fixed costs after those revenue-linked costs come out of each session: fixed monthly cost divided by your fee minus its variable share, rounded up, then spread over the weeks you work.

Overhead as a share of revenue is total monthly overhead divided by expected monthly revenue. We call 25–40% healthy. That band is a planning rule of thumb, not a published standard, so use it to spot outliers rather than to grade your practice.

Overhead per billable hour counts one attended session as one billable hour (the usual clinical hour) and divides total monthly overhead by attended sessions, so no-shows push it up.

Where we have a sourced national figure, the calculator starts there (sources below). Market prices are the median of published prices, monthly billing. Only rent is adjusted for your state, using the state's average Practice Expense GPCI from the Medicare Physician Fee Schedule. Your area may differ, so replace any starting value with your own number.

Two starting values lean low on purpose or by necessity. The session fee is what Medicare pays, which is below many private-pay fees. Rent is a national office-market average applied to a 200-square-foot therapy office and waiting area, which likely understates a furnished office in a city. Both are easy to replace.

Data sources (65)

Frequently asked questions

There is no published standard for solo therapy practices. This calculator uses 25–40% of revenue as a planning range: below it, check that no cost is missing; above it, a large share of each session pays for the practice rather than for you. A telehealth-only practice without an office can sit well below the range and still be complete.

Everything it costs to keep the practice running, except your own pay: rent, your EHR and other software, phone, malpractice and business insurance, license fees and continuing education, the billing code license if you bill insurance, billing and card processing fees, write-offs, and marketing. This calculator doesn't include your salary or draw, income or self-employment taxes, retirement contributions, or one-time startup costs.

Take your fixed monthly costs and divide them by what each session leaves after revenue-linked costs (your fee minus card processing, any billing service, and write-offs), rounding up. The calculator spreads that over the weeks you work and shows it as sessions per week, so you can compare it with the sessions you actually hold after no-shows. If most clients come weekly, that number is roughly the caseload you need.

Office rent depends heavily on location. The calculator scales a national rent baseline by your state's average Practice Expense Geographic Practice Cost Index (GPCI), the index Medicare uses to adjust payments for local practice costs such as office rent and staff wages. We average it across each state's Medicare payment localities, so an office in a major city may cost more than the starting value.

Each one comes from a public source listed under How we calculate, with the date we checked it. The session fee starts at the 2026 Medicare national payment for an hour-long psychotherapy session: $167 for psychologists and $125 for clinical social workers, counselors, and marriage and family therapists, whom Medicare pays at 75% of the psychologist rate. Many private-pay fees are higher. Software, phone, and insurance prices are medians of published prices, and the EHR default is the median of 7 published plans ($69 a month). Rent is a national office-market average applied to a typical therapy office, adjusted for your state, and is likely low for a city office.

No. The calculations run in your browser, and your numbers live only in the page address, which is what makes the share link work. Nothing you type is saved on our servers. If you ask us to email you the results, we keep your email address and nothing else; the privacy policy has the details.