Transparency can be a powerful tool for economic justice. In that spirit, I’m sharing my recurring businesses expenses as a psychotherapist in private practice. Come peek behind the curtain, you curious nerds.

Notice I said “recurring,” as there are substantial isolated expenses throughout the year that won’t be represented here. One year my Macbook gave up and I had to replace it. I recently purchased a new piece of artwork for my home office as intentionally curating the backdrop of my video sessions can be impactful to the work (you can tour my therapy home office here). I have paid a bookkeeper to help with a Quickbooks issue that I could not figure out on my own. As business owners, we do well to expect unexpected expenses. 

It’s also worth noting that I operate a virtual therapy practice out of my home office. If a therapist chooses to see clients in person, their largest business expense will be office space (just like your rent or mortgage payment for your home is likely your largest monthly personal bill). There are certainly benefits to sitting with someone in person. For me, those benefits do not outweigh the many costs. Though I have been trained in Nature Therapy, which I see as a wonderful way to access in person connection without the added expense (plus the all the benefits of nature—heck yes).

These regular expenses I’m sharing with you today do not include the startup costs of establishing a private practice. These also do not include the additional expenses a therapist shoulders during the two year associate period (the required supervision alone is a substantial expense of about $12,000). I do have a template here that outlines everything a therapist needs for both, including links and costs. But the numbers I’m sharing here today are regular, ongoing expenses for a fully licensed therapist.

These expenses are all totaled per year for simplicity and comparison, even though some are actually paid monthly, and these numbers are all current as of 2025.

Legal $121

Psychotherapists are legally required to maintain clinical licensure with their state. In my state of Washington, the renewal fee for the Marriage and Family Therapy (MFT) license is $65 annually.

The operation of a private practice requires a business license. In the state of Washington, the renewal fee for this annual expense $55.

Continuing Education $750

We are legally required to complete continuing education hours every year. There is flexibility in specifically what offerings you choose to take, but each state has specific requirements for categories and quantity. This $750 number is a very conservative annual average for this required expense. (One of the most popular trainings right now is Internal Family Systems (IFS), and their level 1 training alone is $5000. So the costs that therapists pay for ongoing education can be substantial.)

Note: Excavating all the continuing education requirements and tracking them across categories and years is a breeze with the continuing education tracker that is included in my new template bundle alongside an associate hours tracker and private practice startup checklist (with templates specific to each WA therapy license). If you want all the mathing done for you in the prettiest spreadsheets a nerdy therapist like me has ever created , hit the easy button and grab the bundle!

Liability Insurance $244

Every therapist needs insurance to protect their business, their license, and themselves. It’s the only expense on this list that I’ve never used (and hope I never need to). I use CPH Insurance, which seems to be widely seen as the best coverage for the lowest price.

Accounting $458 

Quickbooks is a hefty expense and it feels like old man accounting in the least fun way. User experience aside, it’s necessary. It connects to my business bank account, I can see exactly how much I’m earning and spending in detailed categories, and I can easily generate the report my tax accountant needs at the end of each year.

Wave seems to be a more front-end modern, simple, and inexpensive solution, but I see online concerns about them holding funds for exorbitant amounts of time if you ever collect payments through them, which gives me pause.

Email $78

A Google Workspace subscription allows me to customize my email address to my website (rachel@sagefamily.com) and be HIPAA compliant (by signing their BAA). It’s the ease and integration of gmail with a professional twist. 

Phone $165

We are technically required to have a phone number places like our consent documents and legal filings (even though I don’t publicize my biz phone number anywhere because no thank you to phone calls). Google Voice is my pick for satisfying this requirement. I get a phone number of my choosing that is connected with my biz email account for seamless integration. 

Website $486

You can create a simple and inexpensive website for a therapy practice with a Squarespace domain and therapy-tailored template (which would run you about $300 a year to maintain). My business is bigger than just therapy, so I run my site through Showit. I love this platform for my creativity—the user experience is dreamy, though probably not necessary for everyone.

Electronic Health Record (EHR) $1,284

I use Simple Practice to run the clinical side of my therapy practice (telehealth, scheduling, billing, documentation, etc.). A lot of practitioners are happy with Sessions Health for a significantly lower cost ($468) but also less features. I really appreciate Simple Practice’s comprehensive functionality (it does everything I’ve ever tried to do, and I do a lot).

Credit Card Processing $1,000

This expense is hard to pin down since it’s a percentage of money earned that is deducted before we ever receive the payments. The therapy part of my business pays about $1000 a year in credit card processing fees, but most therapists see twice as many clients as I do (I see 12 clients a week), so that number would be doubled. 

Ivy Pay seems to be the least expensive credit card processing option for therapists, but the integration and automation of Simple Practice is worth every penny to me (we have to factor in the value of our time and energy).

Professional Membership $100

I am disappointed in my professional memberships with AAMFT (American Association for Marriage and Family Therapy) and WAMFT (Washington Association for Marriage and Family Therapy), the national and state professional organizations for my MFT license after two years of membership hasn’t yielded sufficient value for the cost ($271 combined).

I have been especially disappointed in the efficacy of their advocacy. I am flabbergasted by AAMFT’s lack of successful interstate compact progress for MFTs that all of the other licenses are achieving at the hands of their organizations. The ability to practice across state lines is essential in our modern world. I am frustrated by WAMFT’s lack of any progress in improving the debilitatingly long wait for license application processing, which is a delay costing therapy associates significant financial losses.

Directory $359

Psychology Today used to be the main connection point between prospective clients and therapists. I have had a psychology today profile for two years and have never received a single referral from it (I have completed trainings on it, crafting and curating the content over time, to no avail). The general consensus seems to be that directories have lost their footing as therapy farms like Better Help have moved in. I’m including it here because I’m not quite ready to give up on it yet, but I’m very, very close.

Design $119

Canva is the platform that allows me to easily create any and all materials that include design. While not absolutely necessary if your therapy practice isn’t networking and branding with an online presence, most modern therapy practices are (mine included).

Email Marketing $226

Speaking of modern therapy practices running as online businesses, Flodesk is the absolute chef’s kiss of email marketing platforms. It was created by two women and of course it was. If you have dreams of curating a long-term relationship of value with an audience, then add this expense to your list. If you don’t, then skip it. 

Altogether, that brings my total recurring expenses for my therapy private practice to $5,390. Since most therapists see twice as many clients as I do, let’s add $1,000 for the additional credit card processing, bringing the average to $6,390.

I’ve recently been seeing an estimate of around $12,000 in expenses being an average to hold as an expectation (doubled to $24,000 if also paying for an in person office), combining the recurring expenses I’ve outlined here with those irregular expenses I mentioned earlier (laptop replacement, a special training, etc.), but that feels high to my frugal, minimalist sensibilities (I’d rather add guac with reckless abandon than print flyers). One of the things I love about a therapy practice is that it feels light and agile and I intentionally keep it that way with lean expenses.