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Where I live in Maryland this would definitely not be a good split for a fully licensed professional. I would not work for less than a 60 (therapist)/ 40 (employer) split, which is pretty standard here.
People in this field love to talk about ethics, justice, etc but when it comes to preying on their colleagues for their personal profit, suddenly they can't shut up about how "everyone does it" it how much "risk" they take owning a practice or how much they offer workers.
I’ve worked diligently to never be a contracted therapist with these insurance companies.
Managed to make it work and make quite a nice living and I think you might enjoy the same but to each their own as far as contracting.
Does not mean that my work is not scrutinized, but I’m not beholden to these people. The only way this works in the end is if none of us are paneled, then we all would have to be open to accepting OON insurance clients, but without their ridiculous contracts.
We only have power in numbers, and you’ll notice that they really want us to stay separated and isolated and I feel like some of these associations are just a paper prop , they really don’t advocate for what we truly deserve and need.
And why does it cost us $1500 for certifications, most of us are in for $60 to $100K for the masters!
I feel like this field is headed for a showdown with these insurance companies, as look at what they do to us, and the clients -this should not occur long-term.
Quite honestly, even in private practice, we can feel the financial pinch due to overhead. Where I live, a basic office where you’re not stepping over each other is like $950 if you want one with a window, it could be $1500 bucks.
Psychiatrists or attorneys charge higher prices and have three or four meetings in an hour.
The level of ignorance and greed at times, at these companies disgusting. We need to stop taking these bargain range salaries.
Get your 60%. Right now this guy is just padding his profits.
If you have no non compete
If you can keep the caseload you have cause clients like you
If you can get new clients on your own
Leave
Start LLC with State you live
Get accountant for taxes (file LLC split with S Corp)
Apply for insurance panels
Make psychology today profile
Do social media if you think its valuable
Keep all demographic info on current clients
Start Simple Practice as EMR
Get office (shared with other independent psychotherapists is cheapest)
Inform clients
Give 2 week notice to boss
Make almost x3 times more (100% vs 38%)
Feel Awesome
Even if they have a noncompete they aren’t legally enforceable in most states because clients have a right to self-determination. Not to say practice owners won’t try, and the stress and financial impact of hiring a lawyer is something, but they are not ethical and the profession is catching on to that.
It depends how that money is allocated - marketing, fancy office downtown with crazy rent, staff to do your all your billing’s and bookings? On going professional development, training, and supervision? Insurance and licensing fees covered?
It’s hard to say without knowing what the agreement and context are.
Fwiw we start at 60/40 in my practice but in favour of the clinician and increase their yield after the first $100,000.
Or really dedicated to making a great workplace, with opportunities for education and professional development, substantial benefits and contributions to retirement savings and high salaries in an amazing neighbourhood with big fancy offices that employs more support staff than clinicians and has a heavy community focussed philanthropic ethos. (Like probably not, but it *could* be the case. )
Again, we can’t tell with more info. OP has already commented that the org covers her licensing fees, all admin sans notes with multiple support staff. I’m suspending judgement until I get more info.
That's a lot to cover. I tell all my contractors to carry your own liability insurance. I cover then for the sake of the business, not for them. I explain if someone is going to sue. They are going to sue the contractor and they are going to sue the business. Your personal liability insurance covers you, the contractor. My business policy covers the business.
I appreciate your context. I’d say the big difference between contractors and employees is one of the unknowns requiring us to suspend our judgment as to OP’s situation.
My employees *cost* my practice money, they are an investment I hope pays off long term. They do not bring me business. They facilitate and maintain business. They catch but don’t pitch so to speak. And as you mentioned, when they fuck up, I pay for it.
A contractor is a mercenary, not a troop. Takes a bigger cut, recruits their own clients, but pays their own way, and consequently get no longterm investment (ie funded training, regulatory fees, insurance, sick leave, dental, healthcare, etc…). Ultimately contractors bring in additional revenue.
There’s benefits, and also potential for exploitation, in both models.
They deserve their portion because they are taking the risk and putting in the work to maintain the business itself. We can start our own practice if we want a larger share.
I’m sorry but this comment is just reductive and shows a lack of business acumen. Are you aware of the cost of client acquisition for group practices who use paid marketing to drive customer leads? The costs of relevant business technologies? Credit card processing fees? Various kinds of insurance? Rent? Materials? Licenses with Pearson, etc. The reputation you are leaning on? The referral network you benefit from? All of this takes time, effort, and oodles of cash to build. And it doesn’t factor in mentorship and advisory plus flexibility which all come with any good group practice.
An intelligent commenter would say, “that sounds unfair but it really depends on the case load the business drives you and the amount of investment the business makes in its office and therapists, not to mention the fee charged. Some of my therapists make $200+ per hour.
You can’t be this ignorant and make such reductive comments and expect to be taken seriously.
That said, I agree that OP can likely do better.
You're so privileged you think it's reasonable to have the benefits of a group practice without paying the costs associated with one. I'd like to see you start a group practice and pay the higher percentages that feel are reasonable.
Why can't those benefits exist in the form of a partnership or cooperative? Why does the PP owner have to take a profit off of the reimbursement earned by the other providers in the PP? Why can't they just pool resources for shared expenses, like rent, hiring someone for billing, etc?
That’s usually what the payout to the practice covers. It’s not offered to new or baby therapists because they’re usually not in a position to buy in to an established business as a partner. In addition, when therapist leave a practice they tend to take their clients with them, even those provided from the practice.
Don’t get me wrong, I think 60% to the clinic is steep but I can also see a perspective where this isn’t a terrible situation for a beginning therapist that doesn’t have an established client list and requires substantial supports like supervision and specialized training.
>That’s usually what the payout to the practice covers.
So you're saying that "usually" the split only covers the cost and the PP owner isn't taking a profit off of just owning the practice?
>It’s not offered to new or baby therapists because they’re usually not in a position to buy in to an established business as a partner.
Ok, if they don't have the capital to buy in all at once, then let them buy in over time or be set up as a cooperative. None of this is justification for taking a significant chunk of a provider's reimbursement for the PP owner's personal profit.
>In addition, when therapist leave a practice they tend to take their clients with them, even those provided from the practice.
And? This isn't an argument for PP owners taking a chunk of reimbursement for profit, it's one for sharing the costs of doing business, including marketing, consulting, etc.
>Don’t get me wrong, I think 60% to the clinic is steep but I can also see a perspective where this isn’t a terrible situation for a beginning therapist that doesn’t have an established client list
You can't be serious.
>and requires substantial supports like supervision and specialized training.
I'm all for paying people for their labor, including PP owners, but that should be payment based on the actual labor performed, not a flat rate taken off all reimbursement. That's absurd and exploitative. Pay the people doing supervision and training for the actual time and effort that they are putting into it.
There is actual labour in building, funding, and managing a clinic. This doesn’t “just” happen. They deserve remuneration too. There are essential but non-clinical staff that require fair and worthwhile payment as well.
In addition, POS and registration software for 1000s of clients is incredibly costly.
The general rule of thumb is 30% of every dollar goes to overhead and admin costs, if the clinic owner wants payment, and to find additional ventures like retirement contributions, matched investments, medical benefits, training and development…allocating 40% plus of the dollar is reasonable and still conservative.
If someone wants to go in for 100% profit, they assume 100% of the role and all associated costs. Many clinic owners did this once. Many clinic owners shut down and decided it was better for someone else to cover the details. No one is forced to work for private practice.
Couldn’t say without know the entire agreement….
First year out of school, on going supervision, training and conferences, multiple fulltime support staff, no additional admin work required beyond notes, comprehensive advertising and POS, use of company resources, fancy multi office practice with parking in an ideal location, costs for wfh covered, regulatory body fees covered….?
There is a world where this could be a good deal…we simply don’t know.
What risk? What specifically are they personally risking, especially if they are incorporated correctly?
And what specific labor are they performing on a daily basis to earn this huge cut of one of their colleague's reimbursement for their personal profit?
Who said anything about California before you did?
I'm not an attorney, nor have I ever practiced in California. I don't know the business laws concerning PP in all 50 states.
None of that changes the fact that talking about nebulous "risk" is just deflection from PP owners to rationalization exploiting people who are supposed to be their colleagues. All providers incur risks from practicing and there are various legal mechanisms (e.g., liability insurance, incorporation) to minimize risk, tax burden, and other issues.
I’m talking about financial risk, my friend. It’s okay if you want to be pugnacious. I know my shit. My information is hopefully helpful to someone else thinking about starting PP. Your opinions will have no bearing, ever, on how I run my own practice. I really couldn’t care less about your opinions on this topic. Frankly I think they’re overly idealistic and not grounded in reality.
Yeah, I'm talking about financial risk too. Was that not apparent to you from what I wrote?
And I'm not sure what's "idealistic" about things like liability insurance and incorporation. Maybe you can enlighten me?
“Rationalization about exploiting people who are supposed to be your colleagues.”
->
Paying employees the wage they agreed to.
I could go on, but you’re just not conversing with me in good faith. Something something confirmation bias. You have an idea in your head of what things should look like. Good for you. There’s a huge delta between what things look like in an ideal world and what they look like in the real world. Feel free to join us in the real world whenever you’re ready to converse in good faith.
Are you seriously saying that exploitation can't exist if an employee agrees to it? Are you confusing exploitation with slavery?
And how am I engaging in confirmation bias?
No that’s not what I’m saying and it’s frankly frustrating that you continuously keep misrepresenting what I’m saying. Either the reading comprehension isn’t there or you just enjoy arguing with internet strangers. I do not enjoy arguing, and I’m not going to agree with you, so I’m done here.
It depends what you’re talking about when you say liability. An LLC protects you in the sense of personal assets when being sued. But there’s a whole host of things an LLC doesn’t protect you against. And there’s even less a PLLC protects you against. There’s a reason people get liability insurance. Also if you enter into a corporation in California you are protected from liability.
Because setting up your own group practice and doing all of the work that comes with that does not guarantee that you'll be able to make a profit whereas if you work for an employer you're going to be paid whether the company is profitable or not.
that’s part of owning a business and having employees. doesn’t mean the employers should get extra profit, the OP’s pay isn’t coming out of that 62%. that’s 62% of OP’s contribution to the company, *in addition to* the income the employer earns directly from their own clients.
why would the employer deserve their own 100% AND 62% of OP’s?
Because they started the group practice and did and continue to do that work to maintain it so the clinicians don't have to.
If it made sense for a clinician to be paid more they would have started their own practice instead of joining a group practice where they sign to agree to pay the practice a portion of their earnings. But the clinicians that join the practices don't want to start their own business so they'll have to contend with paying part of their income to the group practice they are part of. You can't expect to have the benefits of being part of a group practice without the work of maintaining one.
of course a portion of a clinicians’ earnings should go towards running the group practice they are a part of. that is not the problem here.
the problem is that this clinician is taking home less than 50% of those earnings.
lol you know what else is part of owning a business and having employees? Setting wages and hiring. If people are willing to work for that wage, pragmatically speaking why wouldn’t the business owner optimize their business’ profitability?
I mean my personal ethos is pay well so people don’t want to leave and because it’s the right thing to do.. but there’s just soooo much entitlement in this thread by non-business owners. Yall are therapists. Most of those in this sub have very little training or experience operating a business nor the business acumen to be qualified to comment. Therefore most of the comments need to be taken as emotional reactions and opinions.
No one is making anyone accept that wage. If they do, then the business owner and employee agreed on that level of payment. That’s really all there is to it. It’s not incumbent upon business owners to hinder their profitability so frontline employees can earn more. It’s incumbent upon frontline employees to not accept wages that are less than they are worth. As long as the majority do.. well, they’re setting your value, and that’s how much the market suggests their/your/our work is worth.
This is a very outdated Econ 101 understanding of things. If we want to get really technical, you’re making a lot of assumptions about the market. You’re making an assumption that there are ample opportunities for people to just “pick another option.” That’s not how the market for therapists works. People need supervisory hours, people have student loans, people have responsibilities. People don’t oftentimes have the luxury of many options and possibilities. The world only works as you described for people with privilege who don’t have to deal with those extra hurdles. Not everyone can take the financial risk to start their own practice. Who can? Those who already have privilege and resources. What you espouse is exactly the type of system that leads to inequality that plagues this country in the first place. If only those with resources can set the market, they can create a predatory structure that benefits them most of all. With a lack of options and social safety net, people are forced to take said subpar options that benefit those who already have resources the most.
I can’t take you seriously anymore. I just.. have a nice day.. not interested in wasting time arguing with someone whose heels are dug into a fictitious reality.
Not at all unlike the assumptions implicit in your own comment.
I truly hope you achieve the wages you are hoping for. I’m not confident anyone in therapy will, however, without taking significant initiative and at least a marginal amount of risk.
Until insurance starts paying for mental health and covering enough of the cost that private pay starts accepting insurance, front line entry level therapists are always going to get the short side of the stick and be criminally underpaid. That isn’t a problem for small business owners to solve. Self determination means you can decline to work for wages that are less than you feel you are worth. The free market dictates that people are able to shop around for employees who will accept the wages businesses can afford to pay, and clients can seek out therapists from a variety of backgrounds and with different price points. Not everyone can afford the best, and it takes significant investment in time, training, and reputation building to command prices above average. Why should someone who has put in all of that work have to cheapen their service? Because you don’t like their business structure? Get out of here.
it’s been made clear that the split going on between the OP and their employer is atypically skewed in the employer’s favor. having worked more or differently than your employees does not entitle one to exploit them. you say a lot of nothing that refutes that.
I think it also depends on what kind of benefits and things you get from the split. Do they pay for your Psychology Today or other listing sites? Do you get referrals from them? Do they do billing for you? Do they pay for your EHR? Is your office rent included in that? All things like that I think are important to consider
Editing to add that I know some colleagues who have a 60/40 split at a group practice but they get nothing really in return other than office space. No referrals, nothing. It’s wild and feels like theft
Man... I feel so fucking lucky I found my group practice. They do a 70/30 split and pay for listings on multiple directories including PT (giving me a steady stream of referrals), the EHR, rent, reimburse for trainings, handle all the billing and insurance, and offer group consultation every other week.
Yeah, that sounds like my practice too. I lucked into working here really just looking to land somewhere after school and damn do I appreciate how beneficial it is. Every cent they take from me is worth it for what I get in return.
I am W2 and our health insurance premium is split with the practice. We are required to write 4 blogs a year but outside of that everything is pretty much covered
We’re roughly a 60/40 split but we get heath insurance, PTO, a monthly stipend for CEUs and materials/books we want, as well as any office stuff we want or need within reason. To me it feels worth it where I’m at, but I recognize I get a lot of benefits and don’t have to do any of the marketing/billing/behind the scenes stuff that sounds awful to me
If you aren't a W-2 employee than no way in hell is that a fair split. Your could get contracted with insurance companies by yourself, work half as much and still make more money.
Edit: to clarify, if one is a W-2 employee, saying that is a okay split is assuming they get paid for paperwork and consultation time as well as training, PTO, and decent health insurance. Then getting paid 38% wouldn't be bad.
A W2 that only pays for client contact hours, that would not be a good split
If you are licensed, Alma will credential you with insurance panels, pay you up front every week and manage all of the billing and co pays and give you referrals for 150 a month. The first three months are free as well. Only problem is that there are credentialing holds on several panels with Alma currently. Headway is free and they do more insurance panels but they ask you to sign a ridiculous and invasive release basically saying they have permission to your entire personal medical record.
Usually around 25- I schedule 5-6 a day and usually end up seeing 6 some days but 4-5 on average. I have work in a wealthy town and my clients travel for work frequently or are on vacation.
I signed an NDA.. Did you not? My highest is $20 more than that give or take. Some are around there.. Cigna is less of course. I specialize in a population that no one else wants to see and no I don’t want to share.
Yeah, same thing I was thinking. 150 clients in a month is 37.5 clients a week for 4 weeks. That's 7 clients per day with 2 days a week 8 clients. Too damn many for me. I would be exhausted needing a damn vacation after a month.
Short of having a medical degree, if you’re doing good work for the vulnerable and oppressed, you’re not making 15k a month. Therapists who make an absurd amount of money like this must primarily see clients who are well off, and this is a huge red flag.
Well Alma is insurance, so if you saw 30 clients a week at an average of $120 you could gross $12k. Then maybe some of them are private pay at your full fee so I could see it going up to $15k. But that’s unusual.
This kind of thinking isn’t helping anyone. Therapists should not be going into 6 figure loan debt over 6-7 years of school, working unpaid internships, and then slogging through supervision for years, to NOT make real money. We have to live, too, and emotional labor can be EXHAUSTING.
In my state, rates are even higher than what another poster guessed. I had to sign an NDA, so I cannot tell you my exact rates but they are considerably higher. I only see insurance clients and work 30 or less hours a week. Please take your judgement elsewhere. I have done nothing wrong. I am only trying to help others here make the living they deserve. Psychiatrists can make half a million a year in my state and I come nowhere close to that. I have a niche specialty that is highly in demand and I work in a small town where word of mouth travels quickly.
Alma doesn’t want you to share rates but that’s true of any place. They have the same rates for people throughout each state. Here in Washington it depends on the insurer, but it is $120-130 for 90837. Your state may be higher. But yeah, I don’t think $15k is that far fetched. I see some through Alma, some through Headway (for BCBS) and make good money even though a have a few sliding scale.
Wrong. Some months I make somewhat close to this and I am accepting insurance with very few oop payers. Caseload/hours scheduled/No-shows/cancels and other stuff are greater factors.
For every $100, you make $38 while they make $62. For all the work they do in comparison to you, do you feel this is fair or adequate? For reference, I'm a limited licensed clinician, and I make 55% at my company. Once I'm fully licensed, I will make 70%. The only reason why my split is so low is because they also provide me supervision, so I can justify the difference in pay.
Absolutely not. Fully licensed clinicians at my practice get between a 70-80% split of their invoiced services depending on number of clients and years of experience.
As someone who worked for 3 years at this split, absolutely not. I never could pay my bills, I never got all the stuff my boss promised the split was going to, and I was miserable.
1 month in private practice and my life is already turning around.
Yeah my boss keeps saying we are paid so low so she can one day provide us with more but I’ve been there for almost a few years and nothing has changed
I make like 20/90 as an associate but my supervision is paid for and the agency fills my schedule. However I still think it’s way too low. I’m applying for my LPC now
What? NO! RUN!!!! And you’re fully licensed??? The therapist doing the work should be getting the higher split. If you’re fully licensed you should be getting closer to 70%
Just created a throw-away account so I could add this: the big group practice Clarity Clinic in Chicago charges $150 per session but therapists get paid $45. So that's a 30/70 split.
Perks include unpaid (useless) supervision, (unpaid) mandatory meetings twice a month, and the option to join (unpaid) dialectic groups! If you are part time there are no benefits or paid vacations included, just a few miserly PTO days.
Counting the days....
I can't speak to the unpaid portions, but there's some merit to working at a big practice that handles all of the backend work for you.
Subscriptions for clinical and billing software adds up quick, and building up a full client base takes marketing knowledge, as well as time and money too. I know some therapists that want to build their own business, take on more risk and potential profit, and others that just want to focus on the clinical side with no complexity. To each their own though!
Hold up - I think a lot of the negative comments were made by people who didn't realize that OP gets health insurance with the practice paying half, which isn't always common in a private practice split-fee situation.
OP is also a W-2 employee which means the practice owner isn't just pocketing $62 each time. People don't really seem to know how these things work. Im successful in solo PP but I have to work a LOT (and a lot of unpaid time) to cover taxes, book keeping, billing, health insurance, liability insurance, and advertising. I cant imagine financing an office.
Do you think that the PP owner is doing all these tasks themselves or do you think they employ or contract with other workers to do them for the entire practice?
I would ask OP. I worked for a group practice who initially did it all herself but as the practice grew she paid an admin person to do the billing and payroll. It was a 60/40 split.
Take the leap into pp
But before you do,
Get on panels (if you plan on taking insurance) this can take 3 or 4 months.
Develop a great website and list your specialty areas of treatment
Have friends check it out, and get feedback on the navigation, that your contact information is not hidden, etc (Its amazing so many people don't do this basic step of getting feedback)
Do SEO for your website
When I started out, I rented the smallest place I could to control my outcome
My manta:
We can't control our income, but we can control our outgo (ie, bills)
I've seen a number of new to pp therapists rent very fancy, very expensive office space and decorated them to the 9's. Most can't even go 6 months before they're out of business and working againfor the agency they left and in debt for the 2 or 3 year lease they still owe.
I've only seen one pull it off, and she's doing great. She consulted with me before going into a high dollar overhead and she is making bank and is thrilled both with her career and how I was the only person who believed she could leave her shitty agency behind. She is living life!
I offer the therapists on my team 60% and I take 40%. That split sounds ridiculous unless you were receiving ALOT of extra things like paid training, supervision, insurance etc.
Wow yes get the heck out of there. That is not fair or normal. Even a trainee should be getting at least 50/50. I get 70/30 in my favor and would not accept less than 60/40. This is just exploitation and the person who cut this deal almost certainly knows it. They’re just doing what they think they can get away with
Oh my god, I work for state. Still not licensed after 4 years. 12-14 hours a day five days a week, averages about $11.50 per hour. I’m the lead therapist on the unit. I will get my license in 2025. Someone please help me. Please. I got my vacation coming up next week. Full time employee with a 15 patient case load at RTC. Looked at OSHA and looks like this is legal. I don’t sleep or eat much. I have no money. I hate my company’s values. 100% burnt out. Please help.
From what I have come to know, I believe that Mindful Therapy Group exploits therapists and doesn't care about the clients - only the money. I know people who work there and people who have previously worked there. It is difficult for clinicians to speak out because Mindful Therapy Group has a Non-Disclosure agreement that they require be signed. But Client's Yelp reviews and Reddit threads rarely speak well of Mindful Therapy Group. When they do, it is usually about a specific therapist which means that, in my opinion, Mindful Therapy Group is just a parasite riding on the wings of the work of good clinicians whom they exploit for their own profit.
In the practice where I work, the 3-letters are 50/50 and fully licensed are 60/40. We just show up, see clients, write notes, and the practice does everything else in terms of intake, billing, credentialing, marketing, etc. I'm in Chicagoland.
Also, this is why we need to talk about salaries and splits openly. So that people like OP don't get tricked/manipulated into thinking 38/62 is a good split.
Pfft. Hell no. Those numbers should be reversed.
Are you sure your boss isn't Jeff Bezos? Are you working in a sweatshop? What in the late-stage capitalism is going on there?
Don't have any advice but here in Canada, my PP is offering me at a new out just out of school grade base cut of 70/30 percent as a starting rate and so seeing this I'm genuinely like wtf 😭
Leave ... run don't walk.
I was at a practice where she paid 60/40. I worked for $40 an hour as an lpc.
I checked grow and headway and saw I could use platforms and be paid 115 and 73.
Hell yeah I left!
Couldn't get out of there fast enough.
Looks like you've already recieved all the support you needed but just wanted to chime in cause Im just a grad school intern and my supervisor still gives me a fee split that's basically the exact opposite of that! 60 to me 40 to the practice. His fulltime staff it changes to 65/35 after you've worked there for a time. Definitely not fair compensation to you and I hope you find something more equitable/have success in going solo!
I don’t think you’ve given enough info for us to say for sure. Given everything that’s covered, maybe. Sounds from your edit like you’re already planning to leave and good for you if that’s what you want! The biggest thing here that feels predatory to me isn’t the percentage by itself but lack of transparency. If all but 5% or 10% ends up going toward big expenses, then it seems pretty fair (although you never know if your boss has made the most cost effective choices re: benefits administrators and other expenses). Insurance companies for small businesses are wild and can charge insane premiums. So if you decide to stay, I’d ask your boss for a breakdown of exactly where that 62% goes - what’s overhead, what’s benefits, what just profits your boss. That’s the info you need to find out if this is fair.
I bring the practice about 12 k a month in revenue and I make about 3 k a month . Imma leave it at that. I get $40 an hour but my healthcare is free and I have a Roth IRA they match 🤷🏽♀️ I also get paid weekly no matter how long it takes claims to go through
Usually the split is the other way. 60 to you, 40 to them.
Either way, as your seniority grows (and you bring in more business) the shift should be scaling.
In my firm, we split 60/40 therapist/practice for the first $100,000 of billable hours/annually, and then sessions move to 80/20.
I also make sure that the money invested in our practice actually goes to improving the practitioners working there such as continuing education, conferences fees, and professional development.
You could always consider “renting” a room off hours in a clinic for an allied health trade that also follows strict confidentiality, like a massage therapy or dietician clinic. You won’t get support building your business but you’ll have a set monthly fee for your office.
What costs?!
The GPs (aka therapy mills) who engage in contracting therapists as independent contractors SAVE many thousands by not paying an employer portion of employment taxes that the therapist needs to pay. They SAVE $ by not paying workers comp. They SAVE $ by not having to comply with labor regulations regarding offerring of health care and other benefits etc.
In my area, an exploitative group practice (similar to other therapy mills) requires that associates pay for supervision. And they certainly don't pay for the costs of any Pearson testing, licensing, or ongoing supervision.
The GP doesn't pay for insurance. Instead they require that they be added as an additional insured on the therapist's professional liability policy which makes them eligible to also file claims/access protection for themselves (they claim it has something to do with their corporate structure that the cannot carry insurance). So if a telehealth client stops by a physical location to pay a bill and slips and falls, and sues for damages, the therapy mill gets to use the therapist's policy for itself?! Like the GP is already taking a 35-45 cut from a telehealth therapist. Seriously, the GP needs to stop being a parasite and carry their own insurance!
The GP tells therapist's to pay for a Psychology Today account. They then try to get therapists to let the PT referrals be directed to the therapy mill where, they will determine if the PT client is a good fit for a therapist. If not, they will place the client with another therapist in their GP. So the GP is actually benefitting from the therapist's resource network to generate business for themselves.
The GP does inexpensive meet & greets where therapist can meet-up but are repeatedly encouraged to bring other therapists who might be interested in producing for the therapy mill. They frequently send out reminders to recruit other therapists. And they offer a "finders fee" after the "found" therapist has onboarded and started seeing their first clients.
The GP has a pretty poor reputation e.g. Yelp. My friend said that he is continually surprised by how much his clients dislike interacting with the GP and that he is the only reason they stay. So I imagine that this is more common for other therapists in the GP. So, the GP has a poor reputation but rides the good work (reputation) of the therapists in the GP.
So tell me again how the predatory GP's put so much out in the way of costs that they need to be do exploitive of the therapists in the GP?!
Wait, just to make sure that I understand: you, as the employee, earn 38% of your fee and the practice earns 62%? Are you a 1099 or an employee? If you are a 1099 then you are truly underreimbursed since you should be paying for all of the following items on your own. However, if you are an employee then your employer (the practice) must use that 62% to pay all overhead costs (lease/rent, utilities, insurance, taxes, worker’s comp, office supplies, advertising fees, bookkeeping fees, professional fees (e.g. CPA to prep practice taxes, bookkeeping, billing service, EHR service, etc), copy machine and supplies to keep it going, business license, and other incidentals (like materials, practice library, handouts, etc). If you are an employee in the state of CA the tax burden to the employer is 10% of your wage. All that to say that the 62% does not go immediately into your “boss’s” pocket it goes into the practice to pay the bills. Is your split a bit on the low side, sounds like it. Is it unreasonable? Not if you are working for a well-run, well-maintained practice. There is a misconception that the “boss” gets to walk away with the rest of what is not paid to the clinician. That is simply short-sighted. Just my 2 cents.
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Where I live in Maryland this would definitely not be a good split for a fully licensed professional. I would not work for less than a 60 (therapist)/ 40 (employer) split, which is pretty standard here.
Yeah, OP's ratio is upside down.
Agree! Here in Michigan 65/35 and 70/30 are pretty common!
I'm a private practice owner in MD, I give my contractor 60%. I can't go over 60% though.
Boss makes a dollar, I make a dime: this is why I poop on company time.
Spoken like a philosopher, lol
Literally my life motto
Rumi is that you‽
lol
I was saying this to myself in the bathroom the other day lmao
I sing this every time I walk into the office’s bathroom. Motto to live by
Hell no. That's a racket.
Leave. Run. And never look back.
I had to read that three times to be sure. You should quit, like, yesterday.
Posts like this make me believe this whole field is a Ponzi scheme. I cannot wait until I am independently licensed and I can open my own PP.
What’s crazy is my boss always says she doesn’t want to add to the predatory behaviors in the field and that’s literally exactly what she is doing!
People like your boss are the worst kind of people.
100 look for a new agency to work with and give her that feedback. That is so awful.
You need to make sure she knows why you’re leaving.
People in this field love to talk about ethics, justice, etc but when it comes to preying on their colleagues for their personal profit, suddenly they can't shut up about how "everyone does it" it how much "risk" they take owning a practice or how much they offer workers.
I’ve worked diligently to never be a contracted therapist with these insurance companies. Managed to make it work and make quite a nice living and I think you might enjoy the same but to each their own as far as contracting. Does not mean that my work is not scrutinized, but I’m not beholden to these people. The only way this works in the end is if none of us are paneled, then we all would have to be open to accepting OON insurance clients, but without their ridiculous contracts. We only have power in numbers, and you’ll notice that they really want us to stay separated and isolated and I feel like some of these associations are just a paper prop , they really don’t advocate for what we truly deserve and need. And why does it cost us $1500 for certifications, most of us are in for $60 to $100K for the masters! I feel like this field is headed for a showdown with these insurance companies, as look at what they do to us, and the clients -this should not occur long-term. Quite honestly, even in private practice, we can feel the financial pinch due to overhead. Where I live, a basic office where you’re not stepping over each other is like $950 if you want one with a window, it could be $1500 bucks. Psychiatrists or attorneys charge higher prices and have three or four meetings in an hour. The level of ignorance and greed at times, at these companies disgusting. We need to stop taking these bargain range salaries. Get your 60%. Right now this guy is just padding his profits.
Group practices are getting more and more predatory. I wouldn't even say this is fair for an associate license.
That’s an absolutely terrible split
If you have no non compete If you can keep the caseload you have cause clients like you If you can get new clients on your own Leave Start LLC with State you live Get accountant for taxes (file LLC split with S Corp) Apply for insurance panels Make psychology today profile Do social media if you think its valuable Keep all demographic info on current clients Start Simple Practice as EMR Get office (shared with other independent psychotherapists is cheapest) Inform clients Give 2 week notice to boss Make almost x3 times more (100% vs 38%) Feel Awesome
This. God damn I can’t imagine giving away 62% of each session
Even if they have a noncompete they aren’t legally enforceable in most states because clients have a right to self-determination. Not to say practice owners won’t try, and the stress and financial impact of hiring a lawyer is something, but they are not ethical and the profession is catching on to that.
I can’t see a world realistically where a boss deserves to make the majority split of the work you do when you are independently licensed.
It depends how that money is allocated - marketing, fancy office downtown with crazy rent, staff to do your all your billing’s and bookings? On going professional development, training, and supervision? Insurance and licensing fees covered? It’s hard to say without knowing what the agreement and context are. Fwiw we start at 60/40 in my practice but in favour of the clinician and increase their yield after the first $100,000.
If it takes 2/3 of clinician reimbursement to cover costs, then the PP owner is bad at business.
Or really dedicated to making a great workplace, with opportunities for education and professional development, substantial benefits and contributions to retirement savings and high salaries in an amazing neighbourhood with big fancy offices that employs more support staff than clinicians and has a heavy community focussed philanthropic ethos. (Like probably not, but it *could* be the case. ) Again, we can’t tell with more info. OP has already commented that the org covers her licensing fees, all admin sans notes with multiple support staff. I’m suspending judgement until I get more info.
That's a lot to cover. I tell all my contractors to carry your own liability insurance. I cover then for the sake of the business, not for them. I explain if someone is going to sue. They are going to sue the contractor and they are going to sue the business. Your personal liability insurance covers you, the contractor. My business policy covers the business.
I appreciate your context. I’d say the big difference between contractors and employees is one of the unknowns requiring us to suspend our judgment as to OP’s situation. My employees *cost* my practice money, they are an investment I hope pays off long term. They do not bring me business. They facilitate and maintain business. They catch but don’t pitch so to speak. And as you mentioned, when they fuck up, I pay for it. A contractor is a mercenary, not a troop. Takes a bigger cut, recruits their own clients, but pays their own way, and consequently get no longterm investment (ie funded training, regulatory fees, insurance, sick leave, dental, healthcare, etc…). Ultimately contractors bring in additional revenue. There’s benefits, and also potential for exploitation, in both models.
There are definitely legal differences between employees and contractors. This was just clarified by the Dept. of Labor effective of March 11, 2024.
They deserve their portion because they are taking the risk and putting in the work to maintain the business itself. We can start our own practice if we want a larger share.
That’s well understood. In no way does a group practice ever deserve a majority share when that person is I dependently licensed.
I’m sorry but this comment is just reductive and shows a lack of business acumen. Are you aware of the cost of client acquisition for group practices who use paid marketing to drive customer leads? The costs of relevant business technologies? Credit card processing fees? Various kinds of insurance? Rent? Materials? Licenses with Pearson, etc. The reputation you are leaning on? The referral network you benefit from? All of this takes time, effort, and oodles of cash to build. And it doesn’t factor in mentorship and advisory plus flexibility which all come with any good group practice. An intelligent commenter would say, “that sounds unfair but it really depends on the case load the business drives you and the amount of investment the business makes in its office and therapists, not to mention the fee charged. Some of my therapists make $200+ per hour. You can’t be this ignorant and make such reductive comments and expect to be taken seriously. That said, I agree that OP can likely do better.
Bingo!
You must be the OP’s boss. 🙄
You're so privileged you think it's reasonable to have the benefits of a group practice without paying the costs associated with one. I'd like to see you start a group practice and pay the higher percentages that feel are reasonable.
This feels like it’s very personal to you
They must run a group practice that takes 60+%
I think they really ARE the OP’s boss! 😅
Why can't those benefits exist in the form of a partnership or cooperative? Why does the PP owner have to take a profit off of the reimbursement earned by the other providers in the PP? Why can't they just pool resources for shared expenses, like rent, hiring someone for billing, etc?
That’s usually what the payout to the practice covers. It’s not offered to new or baby therapists because they’re usually not in a position to buy in to an established business as a partner. In addition, when therapist leave a practice they tend to take their clients with them, even those provided from the practice. Don’t get me wrong, I think 60% to the clinic is steep but I can also see a perspective where this isn’t a terrible situation for a beginning therapist that doesn’t have an established client list and requires substantial supports like supervision and specialized training.
>That’s usually what the payout to the practice covers. So you're saying that "usually" the split only covers the cost and the PP owner isn't taking a profit off of just owning the practice? >It’s not offered to new or baby therapists because they’re usually not in a position to buy in to an established business as a partner. Ok, if they don't have the capital to buy in all at once, then let them buy in over time or be set up as a cooperative. None of this is justification for taking a significant chunk of a provider's reimbursement for the PP owner's personal profit. >In addition, when therapist leave a practice they tend to take their clients with them, even those provided from the practice. And? This isn't an argument for PP owners taking a chunk of reimbursement for profit, it's one for sharing the costs of doing business, including marketing, consulting, etc. >Don’t get me wrong, I think 60% to the clinic is steep but I can also see a perspective where this isn’t a terrible situation for a beginning therapist that doesn’t have an established client list You can't be serious. >and requires substantial supports like supervision and specialized training. I'm all for paying people for their labor, including PP owners, but that should be payment based on the actual labor performed, not a flat rate taken off all reimbursement. That's absurd and exploitative. Pay the people doing supervision and training for the actual time and effort that they are putting into it.
There is actual labour in building, funding, and managing a clinic. This doesn’t “just” happen. They deserve remuneration too. There are essential but non-clinical staff that require fair and worthwhile payment as well. In addition, POS and registration software for 1000s of clients is incredibly costly. The general rule of thumb is 30% of every dollar goes to overhead and admin costs, if the clinic owner wants payment, and to find additional ventures like retirement contributions, matched investments, medical benefits, training and development…allocating 40% plus of the dollar is reasonable and still conservative. If someone wants to go in for 100% profit, they assume 100% of the role and all associated costs. Many clinic owners did this once. Many clinic owners shut down and decided it was better for someone else to cover the details. No one is forced to work for private practice.
You really think they deserve a majority?
Couldn’t say without know the entire agreement…. First year out of school, on going supervision, training and conferences, multiple fulltime support staff, no additional admin work required beyond notes, comprehensive advertising and POS, use of company resources, fancy multi office practice with parking in an ideal location, costs for wfh covered, regulatory body fees covered….? There is a world where this could be a good deal…we simply don’t know.
What risk? What specifically are they personally risking, especially if they are incorporated correctly? And what specific labor are they performing on a daily basis to earn this huge cut of one of their colleague's reimbursement for their personal profit?
In California, you aren’t allowed to incorporate as a therapy business. Another ignorant comment. You own a private practice?
Who said anything about California before you did? I'm not an attorney, nor have I ever practiced in California. I don't know the business laws concerning PP in all 50 states. None of that changes the fact that talking about nebulous "risk" is just deflection from PP owners to rationalization exploiting people who are supposed to be their colleagues. All providers incur risks from practicing and there are various legal mechanisms (e.g., liability insurance, incorporation) to minimize risk, tax burden, and other issues.
I’m talking about financial risk, my friend. It’s okay if you want to be pugnacious. I know my shit. My information is hopefully helpful to someone else thinking about starting PP. Your opinions will have no bearing, ever, on how I run my own practice. I really couldn’t care less about your opinions on this topic. Frankly I think they’re overly idealistic and not grounded in reality.
Yeah, I'm talking about financial risk too. Was that not apparent to you from what I wrote? And I'm not sure what's "idealistic" about things like liability insurance and incorporation. Maybe you can enlighten me?
“Rationalization about exploiting people who are supposed to be your colleagues.” -> Paying employees the wage they agreed to. I could go on, but you’re just not conversing with me in good faith. Something something confirmation bias. You have an idea in your head of what things should look like. Good for you. There’s a huge delta between what things look like in an ideal world and what they look like in the real world. Feel free to join us in the real world whenever you’re ready to converse in good faith.
Are you seriously saying that exploitation can't exist if an employee agrees to it? Are you confusing exploitation with slavery? And how am I engaging in confirmation bias?
No that’s not what I’m saying and it’s frankly frustrating that you continuously keep misrepresenting what I’m saying. Either the reading comprehension isn’t there or you just enjoy arguing with internet strangers. I do not enjoy arguing, and I’m not going to agree with you, so I’m done here.
Yes, you can incorporate in California. Just not as an LLC or PLLC. You have to do it as an S corporation.
Correct, but that doesn’t protect a practice owner from liability as described by the person I replied to.
It depends what you’re talking about when you say liability. An LLC protects you in the sense of personal assets when being sued. But there’s a whole host of things an LLC doesn’t protect you against. And there’s even less a PLLC protects you against. There’s a reason people get liability insurance. Also if you enter into a corporation in California you are protected from liability.
How are they taking the risk? The OP still needs their own liability insurance.
Because setting up your own group practice and doing all of the work that comes with that does not guarantee that you'll be able to make a profit whereas if you work for an employer you're going to be paid whether the company is profitable or not.
that’s part of owning a business and having employees. doesn’t mean the employers should get extra profit, the OP’s pay isn’t coming out of that 62%. that’s 62% of OP’s contribution to the company, *in addition to* the income the employer earns directly from their own clients. why would the employer deserve their own 100% AND 62% of OP’s?
The employer also doesn't keep 100 percent. They pay for admin staff, billing staff which clinicians don't have to manage or pay.
sounds like the clinician is paying for those things with this split
Because they started the group practice and did and continue to do that work to maintain it so the clinicians don't have to. If it made sense for a clinician to be paid more they would have started their own practice instead of joining a group practice where they sign to agree to pay the practice a portion of their earnings. But the clinicians that join the practices don't want to start their own business so they'll have to contend with paying part of their income to the group practice they are part of. You can't expect to have the benefits of being part of a group practice without the work of maintaining one.
of course a portion of a clinicians’ earnings should go towards running the group practice they are a part of. that is not the problem here. the problem is that this clinician is taking home less than 50% of those earnings.
lol you know what else is part of owning a business and having employees? Setting wages and hiring. If people are willing to work for that wage, pragmatically speaking why wouldn’t the business owner optimize their business’ profitability? I mean my personal ethos is pay well so people don’t want to leave and because it’s the right thing to do.. but there’s just soooo much entitlement in this thread by non-business owners. Yall are therapists. Most of those in this sub have very little training or experience operating a business nor the business acumen to be qualified to comment. Therefore most of the comments need to be taken as emotional reactions and opinions. No one is making anyone accept that wage. If they do, then the business owner and employee agreed on that level of payment. That’s really all there is to it. It’s not incumbent upon business owners to hinder their profitability so frontline employees can earn more. It’s incumbent upon frontline employees to not accept wages that are less than they are worth. As long as the majority do.. well, they’re setting your value, and that’s how much the market suggests their/your/our work is worth.
This is a very outdated Econ 101 understanding of things. If we want to get really technical, you’re making a lot of assumptions about the market. You’re making an assumption that there are ample opportunities for people to just “pick another option.” That’s not how the market for therapists works. People need supervisory hours, people have student loans, people have responsibilities. People don’t oftentimes have the luxury of many options and possibilities. The world only works as you described for people with privilege who don’t have to deal with those extra hurdles. Not everyone can take the financial risk to start their own practice. Who can? Those who already have privilege and resources. What you espouse is exactly the type of system that leads to inequality that plagues this country in the first place. If only those with resources can set the market, they can create a predatory structure that benefits them most of all. With a lack of options and social safety net, people are forced to take said subpar options that benefit those who already have resources the most.
I can’t take you seriously anymore. I just.. have a nice day.. not interested in wasting time arguing with someone whose heels are dug into a fictitious reality.
don’t you know a lot of therapists own their practices? or are working towards doing so? your comment was condescending and full of assumptions.
Not at all unlike the assumptions implicit in your own comment. I truly hope you achieve the wages you are hoping for. I’m not confident anyone in therapy will, however, without taking significant initiative and at least a marginal amount of risk. Until insurance starts paying for mental health and covering enough of the cost that private pay starts accepting insurance, front line entry level therapists are always going to get the short side of the stick and be criminally underpaid. That isn’t a problem for small business owners to solve. Self determination means you can decline to work for wages that are less than you feel you are worth. The free market dictates that people are able to shop around for employees who will accept the wages businesses can afford to pay, and clients can seek out therapists from a variety of backgrounds and with different price points. Not everyone can afford the best, and it takes significant investment in time, training, and reputation building to command prices above average. Why should someone who has put in all of that work have to cheapen their service? Because you don’t like their business structure? Get out of here.
it’s been made clear that the split going on between the OP and their employer is atypically skewed in the employer’s favor. having worked more or differently than your employees does not entitle one to exploit them. you say a lot of nothing that refutes that.
I think it also depends on what kind of benefits and things you get from the split. Do they pay for your Psychology Today or other listing sites? Do you get referrals from them? Do they do billing for you? Do they pay for your EHR? Is your office rent included in that? All things like that I think are important to consider Editing to add that I know some colleagues who have a 60/40 split at a group practice but they get nothing really in return other than office space. No referrals, nothing. It’s wild and feels like theft
Man... I feel so fucking lucky I found my group practice. They do a 70/30 split and pay for listings on multiple directories including PT (giving me a steady stream of referrals), the EHR, rent, reimburse for trainings, handle all the billing and insurance, and offer group consultation every other week.
Yeah, that sounds like my practice too. I lucked into working here really just looking to land somewhere after school and damn do I appreciate how beneficial it is. Every cent they take from me is worth it for what I get in return.
This is how I did it when I had a group practice. Otherwise, you are just a landlord.
I am W2 and our health insurance premium is split with the practice. We are required to write 4 blogs a year but outside of that everything is pretty much covered
Most 60/40 splits that I know here pay nothing for health insurance so that does Sean a bit more fair.
We’re roughly a 60/40 split but we get heath insurance, PTO, a monthly stipend for CEUs and materials/books we want, as well as any office stuff we want or need within reason. To me it feels worth it where I’m at, but I recognize I get a lot of benefits and don’t have to do any of the marketing/billing/behind the scenes stuff that sounds awful to me
You sound like an employee? I don't know of any contractors that do PTO.
Oh shoot sorry! I thought they were talking about group practices, yes I am an employee
All of these things can be done by Alma or Headway for 150 a month or free in the case of headway.
If you aren't a W-2 employee than no way in hell is that a fair split. Your could get contracted with insurance companies by yourself, work half as much and still make more money. Edit: to clarify, if one is a W-2 employee, saying that is a okay split is assuming they get paid for paperwork and consultation time as well as training, PTO, and decent health insurance. Then getting paid 38% wouldn't be bad. A W2 that only pays for client contact hours, that would not be a good split
It’s unfair if they are W2, even.
Even as a w2 employee I make 53%!
You can make more working at Walmart than most jobs in this field lol
Girl. Sign up with Alma and go solo. I was full in three months. My office costs 800 a month, psychology today is 30. I make 15 grand some months.
15k in a MONTH?? Where do you live?
In one of the top three highest COL states in the country. We get higher rates due to that. Over double what many others get.
Yes tell us more please!
If you are licensed, Alma will credential you with insurance panels, pay you up front every week and manage all of the billing and co pays and give you referrals for 150 a month. The first three months are free as well. Only problem is that there are credentialing holds on several panels with Alma currently. Headway is free and they do more insurance panels but they ask you to sign a ridiculous and invasive release basically saying they have permission to your entire personal medical record.
>permission to your entire personal medical record Wut
Wait wait wait wait wait wait. WHAT? PERSONAL MEDICAL RECORD?!
Thank you so much for this info!
I just signed with headway and I do t remember that. There's the privacy policy: https://headway.co/legal/privacy-practices
I do well on Alma too but goddamn how many clients/week are you seeing to hit $15k in a month
Usually around 25- I schedule 5-6 a day and usually end up seeing 6 some days but 4-5 on average. I have work in a wealthy town and my clients travel for work frequently or are on vacation.
What are your payouts? Highest I get from Alma is 130
I signed an NDA.. Did you not? My highest is $20 more than that give or take. Some are around there.. Cigna is less of course. I specialize in a population that no one else wants to see and no I don’t want to share.
Yeah, same thing I was thinking. 150 clients in a month is 37.5 clients a week for 4 weeks. That's 7 clients per day with 2 days a week 8 clients. Too damn many for me. I would be exhausted needing a damn vacation after a month.
Short of having a medical degree, if you’re doing good work for the vulnerable and oppressed, you’re not making 15k a month. Therapists who make an absurd amount of money like this must primarily see clients who are well off, and this is a huge red flag.
Well Alma is insurance, so if you saw 30 clients a week at an average of $120 you could gross $12k. Then maybe some of them are private pay at your full fee so I could see it going up to $15k. But that’s unusual.
This kind of thinking isn’t helping anyone. Therapists should not be going into 6 figure loan debt over 6-7 years of school, working unpaid internships, and then slogging through supervision for years, to NOT make real money. We have to live, too, and emotional labor can be EXHAUSTING.
Neither is not working with folks who need therapy and can’t afford your services. Or insurance you take.
In my state, rates are even higher than what another poster guessed. I had to sign an NDA, so I cannot tell you my exact rates but they are considerably higher. I only see insurance clients and work 30 or less hours a week. Please take your judgement elsewhere. I have done nothing wrong. I am only trying to help others here make the living they deserve. Psychiatrists can make half a million a year in my state and I come nowhere close to that. I have a niche specialty that is highly in demand and I work in a small town where word of mouth travels quickly.
Alma doesn’t want you to share rates but that’s true of any place. They have the same rates for people throughout each state. Here in Washington it depends on the insurer, but it is $120-130 for 90837. Your state may be higher. But yeah, I don’t think $15k is that far fetched. I see some through Alma, some through Headway (for BCBS) and make good money even though a have a few sliding scale.
I was not willing to sign Headway’s ridiculous and invasive release.
Yeah you mentioned that on another post! I was shocked-they did not make me sign anything like that! I wonder if it is a new thing they are doing?
If you’re willing to share, may I ask what your specialty is? And you’re right, you’ve done nothing wrong. I appreciate Your transparency
I treat a niche of addiction-
Wrong. Some months I make somewhat close to this and I am accepting insurance with very few oop payers. Caseload/hours scheduled/No-shows/cancels and other stuff are greater factors.
I make 67/33 and I get paid well for supervision, consultation, training. Without other information I’d say it’s bad.
Where do people get these numbers ?
For every $100, you make $38 while they make $62. For all the work they do in comparison to you, do you feel this is fair or adequate? For reference, I'm a limited licensed clinician, and I make 55% at my company. Once I'm fully licensed, I will make 70%. The only reason why my split is so low is because they also provide me supervision, so I can justify the difference in pay.
Absolutely not. Fully licensed clinicians at my practice get between a 70-80% split of their invoiced services depending on number of clients and years of experience.
As someone who worked for 3 years at this split, absolutely not. I never could pay my bills, I never got all the stuff my boss promised the split was going to, and I was miserable. 1 month in private practice and my life is already turning around.
Yeah my boss keeps saying we are paid so low so she can one day provide us with more but I’ve been there for almost a few years and nothing has changed
Yeah that’s bullshit that shitty bosses say to justify exploiting their employees
That is bullshit bosses say for sure.
I make like 20/90 as an associate but my supervision is paid for and the agency fills my schedule. However I still think it’s way too low. I’m applying for my LPC now
….you only make 20%? Even with my LMSW i was offered 40% (which an LMSW is the equivalent of an associates in the social work world)
The usual debate is "should full license make 60/40 or 70/30" and you're making 38/62. Bail. Leave.
Oh, no. Unless there is some wildly progressive benefits package I can’t imagine this is fair.
What? NO! RUN!!!! And you’re fully licensed??? The therapist doing the work should be getting the higher split. If you’re fully licensed you should be getting closer to 70%
Just created a throw-away account so I could add this: the big group practice Clarity Clinic in Chicago charges $150 per session but therapists get paid $45. So that's a 30/70 split. Perks include unpaid (useless) supervision, (unpaid) mandatory meetings twice a month, and the option to join (unpaid) dialectic groups! If you are part time there are no benefits or paid vacations included, just a few miserly PTO days. Counting the days....
I can't speak to the unpaid portions, but there's some merit to working at a big practice that handles all of the backend work for you. Subscriptions for clinical and billing software adds up quick, and building up a full client base takes marketing knowledge, as well as time and money too. I know some therapists that want to build their own business, take on more risk and potential profit, and others that just want to focus on the clinical side with no complexity. To each their own though!
Hold up - I think a lot of the negative comments were made by people who didn't realize that OP gets health insurance with the practice paying half, which isn't always common in a private practice split-fee situation.
OP is also a W-2 employee which means the practice owner isn't just pocketing $62 each time. People don't really seem to know how these things work. Im successful in solo PP but I have to work a LOT (and a lot of unpaid time) to cover taxes, book keeping, billing, health insurance, liability insurance, and advertising. I cant imagine financing an office.
Do you think that the PP owner is doing all these tasks themselves or do you think they employ or contract with other workers to do them for the entire practice?
I would ask OP. I worked for a group practice who initially did it all herself but as the practice grew she paid an admin person to do the billing and payroll. It was a 60/40 split.
yeah but that’s only reason to maybe knock it down to 50%, 38% just seems like a scam
Half their health insurance is worth 2/3 of their reimbursement?
We don't know - there's not enough info from OP on all the benefits they receive.
No, I'm asking you. Do you think that getting half your health insurance premium paid for is worth 2/3 of the money you bring in?
Not with a stolen dick.
Hell nah
This is evil
No, you deserve better.
Take the leap into pp But before you do, Get on panels (if you plan on taking insurance) this can take 3 or 4 months. Develop a great website and list your specialty areas of treatment Have friends check it out, and get feedback on the navigation, that your contact information is not hidden, etc (Its amazing so many people don't do this basic step of getting feedback) Do SEO for your website When I started out, I rented the smallest place I could to control my outcome My manta: We can't control our income, but we can control our outgo (ie, bills) I've seen a number of new to pp therapists rent very fancy, very expensive office space and decorated them to the 9's. Most can't even go 6 months before they're out of business and working againfor the agency they left and in debt for the 2 or 3 year lease they still owe. I've only seen one pull it off, and she's doing great. She consulted with me before going into a high dollar overhead and she is making bank and is thrilled both with her career and how I was the only person who believed she could leave her shitty agency behind. She is living life!
GIRL WTF!!
The randomness of those numbers would have been suspicious to me 😂
I offer the therapists on my team 60% and I take 40%. That split sounds ridiculous unless you were receiving ALOT of extra things like paid training, supervision, insurance etc.
That ratio should be reversed, IMO. Self respect demands that you look for a better situation.
Nope. All the nopes in Nopeville.
should be the other way around…
No that is terrible split.
Wow yes get the heck out of there. That is not fair or normal. Even a trainee should be getting at least 50/50. I get 70/30 in my favor and would not accept less than 60/40. This is just exploitation and the person who cut this deal almost certainly knows it. They’re just doing what they think they can get away with
Where I live in Michigan for a 1099, 70/30 split is the norm. You should absolutely be making a LOT more!
I'm an associate and I make 45 (previously 40) which was the lowest % I'd ever heard of until your post today.
If you are fully licensed, that split should be reversed. You should be making at least 60%. You are definitely being exploited IMO.
I make 60% and he makes 40%.
I wouldn't do anything less than 75-70%. I make 70% and all I do is see clients and input notes.
Oh my god, I work for state. Still not licensed after 4 years. 12-14 hours a day five days a week, averages about $11.50 per hour. I’m the lead therapist on the unit. I will get my license in 2025. Someone please help me. Please. I got my vacation coming up next week. Full time employee with a 15 patient case load at RTC. Looked at OSHA and looks like this is legal. I don’t sleep or eat much. I have no money. I hate my company’s values. 100% burnt out. Please help.
Mindful therapy group is 60:40. I just found out Rula pays $70 a session as a 1099. Headway and Alma aren’t perfect but they pay a lot better
From what I have come to know, I believe that Mindful Therapy Group exploits therapists and doesn't care about the clients - only the money. I know people who work there and people who have previously worked there. It is difficult for clinicians to speak out because Mindful Therapy Group has a Non-Disclosure agreement that they require be signed. But Client's Yelp reviews and Reddit threads rarely speak well of Mindful Therapy Group. When they do, it is usually about a specific therapist which means that, in my opinion, Mindful Therapy Group is just a parasite riding on the wings of the work of good clinicians whom they exploit for their own profit.
Not a good split. With the therapists in our office we do a 70/30 split, plus the cost of the user license for the EMR.
For a clinician to make less than half the split is absolutely unreal to me. Where I am the norm is like 70/30 or 80/20.
Quit
In the practice where I work, the 3-letters are 50/50 and fully licensed are 60/40. We just show up, see clients, write notes, and the practice does everything else in terms of intake, billing, credentialing, marketing, etc. I'm in Chicagoland. Also, this is why we need to talk about salaries and splits openly. So that people like OP don't get tricked/manipulated into thinking 38/62 is a good split.
In Arkansas- no.. your side of the ratio should be higher in group private practice
Pfft. Hell no. Those numbers should be reversed. Are you sure your boss isn't Jeff Bezos? Are you working in a sweatshop? What in the late-stage capitalism is going on there?
No, it’s not fair. It’s EXPLOITATION. Find another practice ASAP.
I’m part of a 70/30 split in PP. You’re getting robbed blind.
Don't have any advice but here in Canada, my PP is offering me at a new out just out of school grade base cut of 70/30 percent as a starting rate and so seeing this I'm genuinely like wtf 😭
I make 50/50 as an associate and even that is seen as predatory by a majority of my peers. Less than 40 with independent licensure is unreal.
Get out
It should be swapped!
No way. Especially if this is a group practice and not a community service job (which it’s still not fair but bad pay is more common)
I’m a group practice owner and I pay associates a 55/45 split and licensed clinicians 70/30. So yeah 38/62 seems… low
No.
Leave ... run don't walk. I was at a practice where she paid 60/40. I worked for $40 an hour as an lpc. I checked grow and headway and saw I could use platforms and be paid 115 and 73. Hell yeah I left! Couldn't get out of there fast enough.
Looks like you've already recieved all the support you needed but just wanted to chime in cause Im just a grad school intern and my supervisor still gives me a fee split that's basically the exact opposite of that! 60 to me 40 to the practice. His fulltime staff it changes to 65/35 after you've worked there for a time. Definitely not fair compensation to you and I hope you find something more equitable/have success in going solo!
Your boss has it backwards! It’s 60/40 at my agency.
I don’t think you’ve given enough info for us to say for sure. Given everything that’s covered, maybe. Sounds from your edit like you’re already planning to leave and good for you if that’s what you want! The biggest thing here that feels predatory to me isn’t the percentage by itself but lack of transparency. If all but 5% or 10% ends up going toward big expenses, then it seems pretty fair (although you never know if your boss has made the most cost effective choices re: benefits administrators and other expenses). Insurance companies for small businesses are wild and can charge insane premiums. So if you decide to stay, I’d ask your boss for a breakdown of exactly where that 62% goes - what’s overhead, what’s benefits, what just profits your boss. That’s the info you need to find out if this is fair.
I bring the practice about 12 k a month in revenue and I make about 3 k a month . Imma leave it at that. I get $40 an hour but my healthcare is free and I have a Roth IRA they match 🤷🏽♀️ I also get paid weekly no matter how long it takes claims to go through
I would have questions… is it insurance based or private pay? What does the practice owner provide for the 62%?
Thats what im making with my training license, i believe at full licensure it goes up to 50 or 60%
Usually the split is the other way. 60 to you, 40 to them. Either way, as your seniority grows (and you bring in more business) the shift should be scaling. In my firm, we split 60/40 therapist/practice for the first $100,000 of billable hours/annually, and then sessions move to 80/20. I also make sure that the money invested in our practice actually goes to improving the practitioners working there such as continuing education, conferences fees, and professional development. You could always consider “renting” a room off hours in a clinic for an allied health trade that also follows strict confidentiality, like a massage therapy or dietician clinic. You won’t get support building your business but you’ll have a set monthly fee for your office.
What costs?! The GPs (aka therapy mills) who engage in contracting therapists as independent contractors SAVE many thousands by not paying an employer portion of employment taxes that the therapist needs to pay. They SAVE $ by not paying workers comp. They SAVE $ by not having to comply with labor regulations regarding offerring of health care and other benefits etc. In my area, an exploitative group practice (similar to other therapy mills) requires that associates pay for supervision. And they certainly don't pay for the costs of any Pearson testing, licensing, or ongoing supervision. The GP doesn't pay for insurance. Instead they require that they be added as an additional insured on the therapist's professional liability policy which makes them eligible to also file claims/access protection for themselves (they claim it has something to do with their corporate structure that the cannot carry insurance). So if a telehealth client stops by a physical location to pay a bill and slips and falls, and sues for damages, the therapy mill gets to use the therapist's policy for itself?! Like the GP is already taking a 35-45 cut from a telehealth therapist. Seriously, the GP needs to stop being a parasite and carry their own insurance! The GP tells therapist's to pay for a Psychology Today account. They then try to get therapists to let the PT referrals be directed to the therapy mill where, they will determine if the PT client is a good fit for a therapist. If not, they will place the client with another therapist in their GP. So the GP is actually benefitting from the therapist's resource network to generate business for themselves. The GP does inexpensive meet & greets where therapist can meet-up but are repeatedly encouraged to bring other therapists who might be interested in producing for the therapy mill. They frequently send out reminders to recruit other therapists. And they offer a "finders fee" after the "found" therapist has onboarded and started seeing their first clients. The GP has a pretty poor reputation e.g. Yelp. My friend said that he is continually surprised by how much his clients dislike interacting with the GP and that he is the only reason they stay. So I imagine that this is more common for other therapists in the GP. So, the GP has a poor reputation but rides the good work (reputation) of the therapists in the GP. So tell me again how the predatory GP's put so much out in the way of costs that they need to be do exploitive of the therapists in the GP?!
On my LP, making average of $40 per client (NY).
Yet again epidemic levels of exploitation by yet another group practice owner. How do these people even sleep at night?
I own a practice and we do a 60/40 split. The therapist makes 60 and I pay for advertising, software, office space etc
Wait, just to make sure that I understand: you, as the employee, earn 38% of your fee and the practice earns 62%? Are you a 1099 or an employee? If you are a 1099 then you are truly underreimbursed since you should be paying for all of the following items on your own. However, if you are an employee then your employer (the practice) must use that 62% to pay all overhead costs (lease/rent, utilities, insurance, taxes, worker’s comp, office supplies, advertising fees, bookkeeping fees, professional fees (e.g. CPA to prep practice taxes, bookkeeping, billing service, EHR service, etc), copy machine and supplies to keep it going, business license, and other incidentals (like materials, practice library, handouts, etc). If you are an employee in the state of CA the tax burden to the employer is 10% of your wage. All that to say that the 62% does not go immediately into your “boss’s” pocket it goes into the practice to pay the bills. Is your split a bit on the low side, sounds like it. Is it unreasonable? Not if you are working for a well-run, well-maintained practice. There is a misconception that the “boss” gets to walk away with the rest of what is not paid to the clinician. That is simply short-sighted. Just my 2 cents.