How much does it cost to start a private practice? It's a fair question, and one most therapists never get a straight answer to.
You'll often hear that you should have three months of living expenses saved before making the leap. Ideal, sure. But for most therapists working in agencies, clinics, or group practices, it's not realistic. We were paying our bills and maybe saving a little. We weren't sitting on a cushion.
We can't tell you what your startup costs will be. Every practice is different. What we can do is share real numbers so you have something concrete to plan around, instead of a vague rule of thumb.
How We Started Our Private Practices
Sara and I were both fortunate to bring a portion of our existing caseloads with us when we left our previous positions. That meant when we wrapped up our clinic and group practice jobs, we already had clients on our calendars. Neither of us started from zero: income was coming in from day one, which took a lot of the financial pressure off those first few months.
Your situation may look different, but this context matters. It shaped how much savings we each needed and how quickly our practices became profitable.
For this post, I'm sharing my actual numbers. I opened my practice in New York State in 2020, and I went back through my records so you'd have something concrete to plan around instead of a vague rule of thumb.
What Were My Actual Startup Costs?
When I reviewed my records, my total upfront costs were approximately $3,770. That covered:
- Office furniture
- Office décor
- Two months of office rent
- Two months of internet service
- Two months of SimplePractice
- Other basic setup costs
Adjusted for inflation, that's approximately $4,714 in 2026 dollars, a roughly 24% increase over six years.
How Much of That Was Office-Related?
About $2,515 of that total was tied directly to having a physical office. Strip that out, and a virtual-only version of my practice would have cost closer to $1,256 to start: approximately $1,570 in 2026 dollars.
That was the most eye-opening number when I went back through this. Most therapists assume private practice requires a big upfront investment. A virtual practice often doesn't.
What I'd Do Differently
Skip the stock photography.
I paid for stock images when I built my website. Unnecessary. Most website platforms, including Wix, already come with solid built-in photo libraries. Save the money.
Use a second-line app instead of a second phone.
I set up a separate business number through an app on my phone. It kept my personal number private without the cost of a second phone, a cheap, easy way to maintain a professional boundary.
Do invest in a professional email.
This is one expense worth keeping. A lot of therapists run their practice off a personal Gmail address. A professional, HIPAA-compliant email tied to your domain looks more credible and covers the security bases a healthcare practice actually needs. Mine still runs through Google's business suite, just under my own domain.
Don't forget taxes.
The biggest surprise for most new practice owners: what lands in your account isn't your take-home pay. It's gross income, and a chunk of it goes to the IRS. Put tax money in a separate account that isn't easy to dip into: friction now saves you a panic in April. We set aside 30% of every payment, transferred straight into a tax savings account. Worst case, you've over-saved and tax season comes with a bonus.
Don't forget payment processing fees.
Keeping a card on file makes billing easier and cancellation policies enforceable. It's not free, though. Most platforms charge around 3.15% plus $0.30 per transaction. Small on one session, real money across hundreds a year. Build it into your income projections.
FAQs
Can I start a private practice with $1,000?
Possibly, if you're going virtual, bringing an existing caseload, skipping office costs, and have health insurance covered elsewhere. Even paying for your own insurance, a modest budget can work if income ramps up quickly. Want to pressure-test your own numbers? Our Income Forecaster can help you map out income and expenses before you make the jump.
Do I need an office?
No. Plenty of therapists run fully virtual practices. Office space tends to matter more for clinicians working with kids, adolescents, or older adults; many adult clients prefer virtual for the obvious reasons: no commute, no parking, no wasted time.
What's the biggest expense?
For most therapists, it's either office rent or health insurance, depending on how you're covered. The upside: therapy practices carry far less overhead than most healthcare businesses. No expensive equipment, no big footprint. The therapist is the asset.
Final Thoughts
How much does it cost to start a therapy private practice? It depends. In my case, a virtual practice could have cost as little as $1,570 in today's dollars. A physical office pushed that to roughly $4,714.
Either way, it's less than most people assume, and we'd both tell you that knowing the real numbers makes the decision a lot less intimidating.
We're interested in the emotional and practical realities therapists navigate in private practice, especially around money, sustainability, and decision-making.
