Session counts are up. So where is the money going?
No-shows, EAP underpayments, credentialing gaps. Mental health practices lose money in ways most accountants never track. We track all of them.
A 4-minute test your accountant hopes you skip.
At a glance
Is This Right for You?
This service is for mental health practice owners who recognize these problems:
Need strategic financial leadership? Our Fractional CFO service for mental health practices may be a better fit.
What's Included
How We Work With Mental Health Practices
Mental Health-specific accounting that goes beyond reconciliation.
Provider-Type Financial Tracking
- •Revenue and margin analysis by license type (MD/DO, PhD, LCSW, LPC, LMFT)
- •Reimbursement rate comparison across provider types and payers
- •Supervision cost allocation for pre-licensed clinicians
Session Economics
- •No-show and late cancellation financial impact tracking
- •Revenue per session hour by provider and payer
- •Telehealth vs in-person cost comparison
- •EAP session tracking and profitability analysis
Contractor vs Employee Analysis
- •1099 vs W-2 cost comparison modeling
- •Tax liability and compliance risk assessment
- •Benefits cost impact analysis
Practice Overhead Management
- •Office space utilization and cost per session
- •Technology and EHR cost tracking
- •Marketing and referral acquisition cost per new patient
- •Administrative staff ratio analysis
Results
What Mental Health Practices Experience
| Metric | Typical Outcome |
|---|---|
| Revenue correction | $118,000 recovered through no-show reduction and scheduling optimization |
| Coding compliance | Audit risk eliminated, actual revenue impact neutral (correct coding offset by proper time documentation) |
| EAP strategy | Dropped two lowest-paying EAP contracts, redirected 180 annual session slots to commercial payers worth $79K in additional EAP underpayment recoveries |
Case Study
See The System In Action
14-provider group practice, mix of psychiatrists, psychologists, and LCSWs, two locations plus telehealth. Revenue hit $2.8M but the owner was taking home less than when the practice had 8 providers. Growth felt like it was making things worse, not better.
What we found:
- •Three LCSWs were billing 85% of sessions as 90837 (53+ minute) when session logs showed average duration of 46 minutes. This created audit exposure and inflated revenue expectations
- •No-show rates averaged 19% across the practice but ranged from 8% to 31% by provider — the three highest no-show providers were costing roughly $118K per year in empty session slots
- •Four providers had been in credentialing limbo for an average of 4.5 months, during which the practice absorbed $93K in unbillable sessions
- •EAP sessions represented 22% of total sessions but only 9% of revenue, effectively subsidizing low-paying contracts with higher-paying time slots
The results
$118,000 recovered through no-show reduction and scheduling optimization
Revenue correction
Audit risk eliminated, actual revenue impact neutral (correct coding offset by proper time documentation)
Coding compliance
Dropped two lowest-paying EAP contracts, redirected 180 annual session slots to commercial payers worth $79K in additional EAP underpayment recoveries
EAP strategy
“We thought more therapists meant more profit. Sorso showed us that half our growth was going to EAP sessions and empty chairs.”
— Practice Owner, Northeast
Common Questions About Accounting for Mental Health Practices
Don't pay for reports. Pay for progress.
Take the 4-minute financial assessment—and find out if your books are helping or hurting your mental health practice.
The test your accountant hopes you skip.