Clinician Cost Calculator

Understanding Pay Model Risk

Not all pay structures carry the same financial exposure. Know what you're signing up for before you set a rate.

Lowest Risk
Commission

You pay only when you collect. If a client no-shows and you collect a fee, the clinician gets their cut. If insurance claws back payment, you owe nothing. Cash flow is fully aligned with revenue. That said, this model is becoming less viable as states tighten wage and timely pay laws — I don't recommend it, and I'm including it here as a comparison only. If you're currently using commission, please consult an employment attorney in your state before continuing.

Medium Risk
Hourly

You owe for every hour worked regardless of collection. Insurance lag means paying clinicians before revenue arrives. Timely pay laws require full payment even if insurance claws back or a client doesn't pay.

Medium-High Risk
Hourly + Commission (Hybrid)

The base hourly is always owed regardless of collections — same timely pay exposure as straight hourly. The commission portion can be held until collected, which partially hedges your risk.

Highest Risk
Salary

Full payroll obligation regardless of caseload, cancellations, insurance delays, or clawbacks. Requires maintaining cash reserves to cover payroll gaps. Greatest exposure if census drops suddenly.

Clinician Pay & Cost to Practice Calculator

APractice Basics
Average session rate collected Your actual average after insurance adjustments — not your billed rate.
$
Employer payroll taxes — FICA, FUTA, SUTA (W2 only; enter 0 for ICs) Estimated 10%. Verify your state rate at gusto.com/tools/employer-tax-calculator
%
Workers comp (W2 only; enter 0 for ICs) Typically 0.5–2% of gross wages for office/clinical roles. Varies by state and job classification.
%
Sessions per month (target) For salary, use annual sessions ÷ 12.
Calculated
Total employer burden % (payroll taxes + workers comp)0.0%
BPay Rates — Enter All Four Models

Fill in the rate you're considering for each model. Leave a model's fields blank to exclude it from results. Higher-risk models should generally offer lower total compensation to offset your increased financial exposure as the practice owner.

Commission
%
Hourly
$
$
Hourly + Commission (Hybrid)
$
%
$
Salary
$

Admin hours are used to calculate your implied clinical hourly rate — what you're actually paying per clinical hour once admin time is factored in.

CBenefits (Monthly, Per Clinician)
Health insurance (your cost per clinician)
$
PTO (monthly cost) Estimate: annual PTO days × daily rate ÷ 12
$
Paid sick time (monthly cost)
$
Retirement matching (monthly contribution)
$
Calculated
Total benefits / month$0.00
DClinician Opex (Monthly, Per Clinician)

These are the operating costs tied directly to employing this clinician — separate from your practice-wide overhead.

Directory listing(s) Psychology Today, Headway, Alma, TherapyDen, etc. — total monthly cost
$
EHR / software (per clinician seat)
$
Phone line / extension
$
Email account
$
License renewal (amortized monthly) Annual renewal fee ÷ 12
$
Malpractice insurance
$
Calculated
Total clinician opex / month$0.00
EOffice Space
Monthly rent (total for location)
$
Number of usable office rooms
Days / month offices are used M–F only = 20 days. 7 days/week = 28 days.
Target billable hours per room per day 8 hours is standard for a full day.
Calculated
Rent cost per hour (while clinician is in room)$0.00
Monthly rent cost at target session volume$0.00
Important note on commission pay: Commission-based pay is becoming legally prohibited in a growing number of states due to tightening timely pay and wage laws. Many states now require clinicians be paid within a specific window of when work is performed — regardless of whether the practice has collected. Verify legality in your state and consult an employment attorney before using a commission model.
Timely pay laws apply to all compensation models: Most states require employees be paid for all hours worked within the pay period — even if the practice has not yet collected from insurance or clients. All practices must maintain adequate cash reserves to cover payroll independent of collections. No-shows and late cancels are only covered if your practice collects and enforces a cancellation fee.

Built for group practice owners by The Group Practice Exchange. Estimates only — consult your accountant and an employment attorney for tax and wage lawguidance. Check your employer tax rate →

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Liath | Co-Owner and Deputy Director
Person Centered Tech (Workshops) Liath Dalton is PCT’s deputy director and a co-owner. As the group practice service plan manager, Liath oversees the vendor review program and is the account manager for group practices working with PCT. She loves helping practices find solutions that meet the security and functionality needs that allow them to meet clients where they are. Liath’s consultation area of expertise is focused on selecting the right combination of services and tech that not only meet the legal-ethical needs of mental health practices, but also the functionality, efficiency and cost-effectiveness needs as well.

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Business Strategist and Fractional Integrator
Casey Gromer is an MBA graduate with over two decades of experience in business and marketing. Currently serving as a business strategist and Fractional Integrator for group practice owners, Casey excels in crafting business management systems that drive profit and accountability. Casey specializes in accountability, performance measurement, leadership, structuring teams, business planning, business systems and operation

Niki Ramirez

Founder, CEO | Principal Consultant
HR Answers LLC Niki Ramirez is the Founder and Principal Consultant at HR Answers, LLC a firm dedicated to providing practical human resources guidance that leaves a big impact on small business success. Niki is a certified HR professional with leadership and HR experience spanning well-over 20 years, including: serving in operational management and leadership roles, community college adjunct faculty, and as a human resources executive. Niki holds an MBA in HR Management and three different HR certifications. She carries with her a strong desire to educate and empower employees and their leaders to work in partnership to design and implement meaningful human resources programs that drive the success of their organizations and increase their bottom line!

Julie Herres

Founder, CEO | IRS Enrolled Agent and Financial Advisor
GreenOak Accounting Julie Herres is an accountant and the owner of GreenOak Accounting, a firm that specializes in working with therapists in private practice. Julie's goal is for every practice to be profitable! She's on a mission to give practice owners financial peace of mind by helping them make data-driven business decisions. Julie and her team have worked with hundreds of private practice owners, so they are uniquely positioned to be a trusted advisor to clients. Julie also hosts the Therapy For Your Money Podcast, where she talks about all things money & finance for private practices. The GreenOak Accounting team: Helps practice owners make daunting financial decisions by acting as a trusted advisor who is intimately familiar with their situation Coaches practice owners from the mindset of "I don't understand the numbers in my practice" to "I feel confident and empowered to make the right business decisions!" Guides practice owners from having no cash in the bank to having healthy reserves using the Profit First methodology

Maureen Hermann

Founder, CEO of TGPE and Urban Wellness
The Group Practice Exchange Maureen is the owner of a multi location group practice in Chicago, Urban Wellness Counseling, owner of The Group Practice Exchange and co-owner of the former Group Practice Builders. Maureen loves creating a safe space for clinicians and clients to do amazing work together, and equally enjoys helping group practice owners start and scale (and growing alternate passive income streams!).
 
Her Open Office Hours/Q+A each month will be Ask Me Anything style on everything from startup to seven figures.