Planning tool

Therapy Cash Flow Calculator

Estimate the annual revenue, completed sessions, and scheduled sessions your practice needs. Group practices can also model contribution, margin, and break-even per clinician.

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Enter your numbers

Step 1. What you need personally

Your draw and personal costs.

Applied to profit after business costs, not to the costs themselves.

Step 2. What the practice costs to run

Annual business costs.

Step 3. Revenue inputs

Use collected revenue, not billed charges or your posted fee.

Last 90 days of collected clinical revenue ÷ completed sessions.

Completed appointments ÷ scheduled appointments; not a collection rate.

Step 4. Capacity assumptions

Compare the result with the week you want to work.

When This Calculator Helps

The math is the same whether you are opening a practice or running one. These are the moments it answers a question you are asking.

  • Setting or raising your fee. Work backward from what you need to take home instead of guessing at a number, or checking what the practice down the street charges.
  • Deciding whether to take insurance, or drop a panel. Run the same personal target at two collected rates and see the difference in weekly appointments rather than in the abstract.
  • Leaving a group practice or agency job. Find the caseload that replaces your salary before you give notice, with the tax reserve calculated on profit rather than on revenue.
  • Feeling overworked without knowing why. If the sessions your income requires exceed the week you want, the calculator shows it as a number instead of a feeling.
  • Hiring your first clinician. Group mode shows the sessions a new clinician has to deliver to cover their own compensation and their share of overhead, and how long the ramp takes.
  • Planning time off. Weeks worked is an input, so you can see what four weeks away costs and what caseload pays for it.

How the Math Works

Tax Applies to Profit, Not to Costs

Business costs come out before tax, so the reserve is calculated on what is left rather than on the whole target. This is where most caseload worksheets go wrong, including an earlier version of ours.

Required revenue = business costs + personal need ÷ (1 − tax reserve rate)

The version that adds a tax percentage on top of costs and pay understates what you need, and it understates by more as the rate rises. That is the direction that plans too few sessions.

From Annual Revenue to a Week

Completed sessions per year = required revenue ÷ collected revenue per session
Completed sessions per week = completed sessions per year ÷ weeks worked
Sessions to schedule per week = completed sessions per week ÷ completion rate

What Break-Even Means Here

One thing only: the completed sessions one clinician has to deliver each week to cover their own compensation, the costs that scale with having them on the team, and their share of practice fixed overhead. It is before owner pay. If you draw a salary, enter it under practice fixed overhead.

Costs are sorted three ways because they behave differently. Practice fixed overhead moves with neither headcount nor sessions. A software seat or admin support is fixed per clinician and moves with headcount only. Processing fees move with each session. Treating a per-clinician cost as a per-session one makes break-even depend on its own answer and reports it lower than it is.

Assumptions and Limits

  • Every default is an author assumption for modeling. None of them is an industry average, a benchmark, or a recommended value.
  • The results are only as good as your collected revenue figure. Use your own records rather than a published reimbursement average, which varies by code, state, payer, license and setting.
  • Self-employment tax is one input, not a whole tax picture. Federal, state and local income taxes sit on top of it, and the reserve here is a single blended planning rate. Confirm it with a CPA or an enrolled agent.
  • Salary and revenue split are modeled as costs. Neither is a legal classification. Whether a clinician is an employee or a contractor depends on the working relationship and on federal and state law, so review it with an employment attorney or a CPA before you hire.
  • Capacity is checked against the maximum hours you enter. There is no research-backed universal safe caseload, and this tool does not suggest one.

Learn More

See the full guide to therapy practice caseload math for the reasoning behind each field, including why scheduled, completed, and collected are not the same, and why gross and net collection rates use different denominators.

If you want help with the demand side of the gap this tool shows you, see how we work with therapy practices.

The Demand Side Is Our Side

This tool shows how many sessions your practice needs. If the gap between that and your current caseload is a marketing problem, that is the part we do: websites and search marketing for therapy practices.

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