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Clinician Pay & Cost to Practice Calculator

Enter your numbers once. See what each pay model really costs — and whether your structure is financially sustainable.

Clinician Cal

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

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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 law guidance. Check your employer tax rate →

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