Private Practice Financial Model (2026)

At this fee, this caseload, and these expenses, here is what you take home each month, here is the week that breaks even, and here is the size of the hole year one digs before it fills. Everything else in the leap to private practice is commentary on those three numbers, and this workbook computes all three from your inputs.

What you get

• Monthly Model: payer mix, contracted rates, collections and no-shows blended into what a steady month pays
• Break-Even: expenses restated as sessions per working week, and the caseload your income target requires
• Scenarios: insurance-heavy, balanced and private-pay side by side
• Year One: a month by month ramp against startup costs that finds the cash trough
• A six tab Excel workbook that also works in Google Sheets and LibreOffice

Who it is for

Therapists planning the leap to private practice, or checking the numbers on one they have started.

How it works

The Monthly Model blends your payer mix, contracted rates, collection rates, and no-show reality into what a steady month actually pays, including the effective hourly figure to hold up against agency pay. Break-Even restates your expenses as sessions per working week, then works backwards from your income target to the caseload it truly requires, booked ahead of no-shows. Scenarios runs the same practice insurance-heavy, balanced, and private-pay, side by side, so the biggest financial fork in a new practice gets argued with your numbers instead of your feelings. Year One ramps your caseload month by month against startup costs and finds the cash trough, which is the savings a launch actually requires and the reason practices die in month four rather than month ten.

Every assumption sits in its own labeled cell. Nothing is hardcoded, so the model recalculates as your numbers change, and the quick guide covers the inputs worth distrusting, starting with the growth cell people flatter themselves in.

Format

Excel workbook, six tabs, works in Excel, Google Sheets, and LibreOffice, plus a printable quick guide. Expense inputs include your own health insurance and a variable cost rate for percentage-based billing, because leaving those out is how a model flatters itself.

A planning tool, not accounting, tax, or investment advice. Taxes are modeled as a set-aside percentage you choose with your accountant.

Walkthrough video: a look inside before you buy.