Search for group private practice therapy and most of what comes back is group practices' own home pages: teams of clinicians showing clients who works there. This guide is for the other side of that search, the solo therapist deciding whether to build one. It covers group practice vs solo practice, the IRS and Department of Labor tests for W-2 employees and 1099 contractors, how splits and salaries work, entity and ownership rules, supervising associates, credentialing, the HIPAA program a group needs, hiring and onboarding, a website that books several clinicians, and a 6-month plan you can copy.
Group practice vs solo practice: what changes
A solo practice earns what you bill, minus your costs. A group practice earns that plus the margin on other clinicians' sessions, minus the costs of employing or contracting them and the time you spend running the group instead of seeing clients. The second half of that sentence is where most of the change sits.
What you gain in a group:
- Capacity.You can say yes to referrals you'd otherwise send away: evenings, a specialty you don't offer, a language you don't speak, clients in a state where a colleague is licensed.
- Income beyond your own hours.Part of each session your clinicians hold goes to the practice, so the practice can earn while you're not in session.
- Colleagues.Case consultation, coverage when you're away, and a place to supervise and train newer clinicians.
- Something that outlasts you.A group with its own contracts, staff and reputation is easier to hand on or sell than a solo caseload.
What you take on:
- Management.Hiring, payroll, schedules, complaints, performance and the day someone quits. Owners interviewed by Social Work Today in 2025 described cutting their own caseloads as their practices grew; one said, "I tried to keep a full caseload when I started this, and that hasn't worked out" (Social Work Today, Starting a Group Practice).
- Legal exposure.Worker classification, wage and hour rules, supervision liability and HIPAA duties for everyone who touches records.
- Cash flow.You pay a new clinician, or carry their costs, while their caseload fills.
- Less control over the work.Clients see your practice's name on care you didn't give.
Signs you might be ready
- You turn away clients most weeks, and they'd fit a colleague's hours or specialty.
- Your own systems already work: booking, intake paperwork, notes, billing and policies run without you fixing them each week.
- You have cash set aside to cover several months of a new clinician's costs before their caseload pays for itself.
- You want to manage and supervise, not only to earn more.
- You've written down what the group is for: who it serves, and what a client gets there that they wouldn't get from you alone.
If the last point is empty, start with the business plan for private practice and add hiring, pay and supervision sections to it. If you haven't opened your own practice yet, how to start a private practice covers the solo steps that come first.
Three ways to grow past solo
- A collective.Each clinician runs their own practice: their own entity, NPI, insurance, records, BAAs, fees and website. You share rent, maybe a front desk, maybe a name. This is closest to solo, and the clinicians aren't each other's employees. The catch: if you share a name, clients may believe they're dealing with one practice. Ask a lawyer how to present a shared brand, and how a shared front desk that sees everyone's client information should be set up under HIPAA.
- A group with 1099 contractors.The practice is the business, and clinicians work for it as independent contractors. It's lighter on payroll and benefits, and the hardest model to get right, because a therapy group usually controls the very things the classification tests look at (next section).
- A group with W-2 employees.The practice employs clinicians, withholds taxes, may offer benefits and can direct the work. It costs more per clinician and carries wage and hour duties, but it fits how most groups actually work, and in California it's the only paid option for pre-licensed associates.
Many groups mix the last two. Each person's status still has to stand on its own facts.
W-2 employees vs 1099 contractors
The label you pick doesn't decide it. The IRS says a contract calling someone an independent contractor "is not sufficient to determine the worker's status" (IRS, Type of relationship). The Department of Labor says signing an independent contractor agreement "does not make a worker an independent contractor," and that being licensed by the state doesn't settle it either (DOL, Fact Sheet 13).
Three sets of rules apply, and they don't match: the IRS test for federal taxes, the Department of Labor test for minimum wage and overtime, and your state's tests for state wage laws, unemployment insurance and workers' compensation. A clinician can be a contractor under one and an employee under another.
The IRS test: control and independence
The IRS sorts the evidence into three categories (IRS, Independent contractor or employee?):
- Behavioral:"Does the company control or have the right to control what the worker does and how the worker does his or her job?"
- Financial:"Are the business aspects of the worker's job controlled by the payer?" This covers how the worker is paid, whether expenses are reimbursed, and who provides tools and supplies.
- Type of relationship:written contracts, employee-type benefits, whether the relationship will continue, and whether the work is "a key aspect of the business."
There is no magic number of factors, and the IRS asks you to "document each of the factors used in coming up with the determination." Three details matter for therapy groups:
- The right to control counts, even unused."A worker is an employee when the business has the right to direct and control the worker," whether or not it actually does. The IRS adds that a business "may lack the knowledge to instruct some highly specialized professionals" and that the question is whether it "has retained the right to control the details" (IRS, Behavioral control). Your clinicians' clinical judgment being their own doesn't make them contractors.
- Training is strong evidence.Training workers on how to do the job "is strong evidence that the worker is an employee," and ongoing training on procedures and methods "is even stronger evidence."
- Presenting their work as yours.The IRS example: a law firm that hires an attorney is likely to "present the attorney's work as its own," which points to employment. A team page that lists clinicians as your practice's therapists does the same.
The Department of Labor test: economic reality
For minimum wage and overtime under the Fair Labor Standards Act, the question is whether the worker is "economically dependent on the employer for work" or "in business for themself." The Department's regulations (29 CFR part 795, effective March 11, 2024) weigh six factors, none decisive (DOL, Fact Sheet 13):
- Opportunity for profit or loss depending on managerial skill: does the clinician negotiate pay, market themselves, decide what work to take?
- Investments by the worker and the employer: does the clinician invest in a business of their own, or do you pay for the office, software and marketing?
- Degree of permanence: open-ended and continuous points to employee status.
- Nature and degree of control: who controls hiring, scheduling, prices, pay rates and the ability to work elsewhere.
- Whether the work is an integral part of the business: therapy is integral to a therapy practice.
- Skill and initiative: skills used with business initiative point to contractor status; skill alone points to neither.
The Department's own nursing example reads like a therapy group. A nursing home sets the schedule with staff input, assigns the work and bars nurses from working for other homes; even though nurses work "without close supervision," those facts "indicate employee status under the control factor." A nurse who keeps a website, sets their own prices and serves several homes points the other way.
One helpful line: control "for the sole purpose of complying with a specific, applicable federal, state, tribal, or local regulation" doesn't weigh toward employment. Requiring HIPAA training is compliance. Requiring your note style, your hours and your intake line is control.
Status as of October 2026: Fact Sheet 13 says the 2024 rule "remains in effect for purposes of private litigation" while its legality is litigated, points to Field Assistance Bulletin 2025-1 (May 1, 2025) for the Wage and Hour Division's current enforcement position, and notes a proposed rule published February 26, 2026 (91 FR 9932) whose comment period closed April 28, 2026. Check the DOL misclassification page for a final rule before you rely on any of this.
State tests can be stricter
California is the sharpest example. Under its ABC test, a worker is an employee unless the hiring business shows all three: the worker isn't under its control and direction in doing the work, the work is outside the usual course of its business, and the worker is customarily in an independent business of the same kind (California Labor and Workforce Development Agency, ABC Test). The agency's summary of the Supreme Court's reading of the second prong: "Contracted workers who provide services in a role comparable to that of existing employees will likely be viewed as working in the usual course of the hiring entity's business." A therapy practice contracting therapists to provide therapy has a hard time with that prong.
California's list of licensed occupations that get the older Borello test instead names "Certain licensed physicians, surgeons, dentists, podiatrists, psychologists, or veterinarians." LMFTs, LCSWs and LPCCs aren't on it. The agency also says workers "may be considered employees and have protections under California law, even if they are determined not to be employees under federal law" (LWDA, Employment status FAQ). Other states have their own tests, often one for unemployment insurance and another for wages. Look up your state's labor department and unemployment agency, and ask an employment lawyer.
Red flags in a therapy group's contractor model
Each of these points toward employee status under at least one of the tests above:
- You assign clients from your intake line, and the clinician can't really decline them.
- You set their hours or require minimum availability.
- They must use your note templates, scripts or methods, beyond what the law requires.
- You train them in how your practice does therapy.
- They can't see clients anywhere else.
- You set their fees, and they don't negotiate their pay.
- You pay for the office, the software, the phone line and the marketing.
- The arrangement has no end date and is their only work.
- Your website and email signatures present them as your team.
A group where most of these are true is hard to defend as a contractor model. That doesn't make contractors impossible: a clinician with their own practice, their own clients and their own rates who sees some clients through yours may genuinely be one. Write down your reasoning for each person, as the IRS asks.
Pre-licensed associates are a special case
In California, associates can't be contractors at all. For associate marriage and family therapists the law says: "A trainee, associate, or applicant for licensure shall only perform mental health and related services as an employee or volunteer, and not as an independent contractor" (Business and Professions Code 4980.43.3(a)). The rules for associate clinical social workers (4996.23.2(a)) and associate professional clinical counselors (4999.46.3(a)) say the same. At licensure, an employed associate gives the board "copies of the W-2 tax forms for each year of experience claimed" (BBS statutes and regulations, January 2026).
The same section adds rules a group owner must build around:
- An associate "shall not receive any remuneration from patients or clients and shall only be paid by their employer, if an employee."
- An associate "shall have no proprietary interest in their employer's business and shall not lease or rent space, pay for furnishings, equipment, or supplies."
- An applicant can't work or volunteer in a private practice or professional corporation until the board has issued the associate registration.
Other states write this differently, and some say nothing directly. Supervision itself means control over the work, which tends to point toward employment under the tests above. Ask your board what settings and pay arrangements count for supervised hours before you hire. Our clinical supervision guide covers the supervision side.
What misclassification costs
- Federal taxes.If you treat an employee as a contractor "and you have no reasonable basis for doing so, then you may be held liable for employment taxes for that worker" (IRS). Relief under Section 530 needs a reasonable basis, consistent 1099 filing, and no history of treating similar workers as employees.
- Wages.Misclassified employees "may not receive the minimum wage and overtime pay to which they are entitled" (DOL, Misclassification), which can mean back pay.
- State claims.California lists restitution and penalties for minimum wage and overtime, unemployment insurance taxes, workers' compensation, the employees' share of payroll taxes, and interest (LWDA FAQ).
If you're unsure, either party can file Form SS-8 for an IRS determination; the IRS says it "may take at least six months." If you've already been treating employees as contractors, the Voluntary Classification Settlement Program (Form 8952) lets eligible businesses reclassify them going forward with partial relief from federal employment taxes. Talk to a CPA before you file either.
Paperwork for each
For employees:
- Form W-4 for federal income tax withholding, plus your state's form if it has one.
- Form I-9 for every hire: "All U.S. employers must properly complete Form I-9 for every individual they hire." Keep it for three years after the hire date or one year after employment ends, whichever is later (USCIS, Form I-9).
- A new hire report to your state "within 20 days of hire," or sooner where the state requires it (ACF, New Hire Reporting).
- Payroll tax deposits, state unemployment insurance and workers' compensation coverage as your state requires.
For contractors:
- Form W-9 before the first payment.
- Form 1099-NEC each year. For tax years beginning after 2025 the reporting threshold rose to $2,000, and it may be adjusted for inflation from 2027 (IRS, Instructions for Forms 1099-MISC and 1099-NEC).
- A written agreement, remembering that the agreement doesn't decide the status.
A check to run for each clinician before you choose:
Compensation models: splits, per-session pay and salary
There's no standard pay for a group practice clinician. Rather than quote figures that won't fit your market, this section explains how each model works and gives you a worksheet to run your own numbers. For what owners themselves take home, see our guide to private practice therapist salary.
The common models:
- A percentage split.The clinician gets a fixed share of what the practice collects for their sessions, and the practice keeps the rest. Used with contractors and, as commission pay, with some employees.
- A flat amount per session.A set payment for each completed session, sometimes different by service (intake, individual, couples) or by license level.
- Hourly pay.For time worked, sessions or not.
- Salary.A fixed amount for an expected caseload, sometimes with a bonus above it.
- A hybrid.A base salary or hourly rate plus a per-session amount above a set number of sessions.
What a 70/30 split means
A 70/30 split gives one side 70 percent of what's collected for a clinician's sessions and the other side 30 percent. Groups quote it both ways round, so write down which side is which, then settle the details that change what a split is worth:
- Collected or billed?A split of what's billed pays out on money the practice may never receive, which is why many groups split what's collected.
- When is it paid?Insurance can pay weeks after a session. Decide whether the clinician is paid when the session happens or when the money arrives.
- No-shows and late cancellations.Does the clinician share a late-cancel fee, and what happens when it isn't collected?
- Denials and clawbacks.If a payer takes money back months later, does the clinician's share come back too?
- What the practice's share covers.Office, software, billing, intake, marketing, supervision. A higher practice share that includes billing and a full intake pipeline is a different offer from a lower one that doesn't.
Per-session pay for W-2 clinicians: check the wage rules
Employees are owed at least the federal minimum wage and overtime for hours over 40 in a week "unless a relevant exemption applies" (DOL, Fact Sheet 13). The professional exemption needs, among other things, pay "on a salary or fee basis" of at least $684 a week (29 CFR 541.300; DOL, Fact Sheet 17D).
Per-session pay is the trap. The regulation says a fee "is paid for the kind of job that is unique rather than for a series of jobs repeated an indefinite number of times and for which payment on an identical basis is made over and over again" (29 CFR 541.605). Weekly sessions paid the same way each time may not count as a fee basis. If your W-2 clinicians are paid only per session, ask an employment lawyer whether you need to track their hours and pay at least minimum wage and overtime for all time worked, including notes, meetings and supervision. Many states set higher minimums and their own overtime rules.
If you bill Medicare or Medicaid
The federal Anti-Kickback Statute makes it a crime to pay "remuneration to induce or reward patient referrals" for services federal programs pay for. Safe harbors protect some arrangements, including "payments to bona fide employees" and some personal services agreements, but "an arrangement must fit squarely in the safe harbor and satisfy all of its requirements" (HHS OIG, Fraud and abuse laws). A percentage split with a contractor, or any pay tied to the referrals someone brings in, is worth a health care attorney's review. Some states also restrict fee splitting.
Per-session worksheet
Fill in your own numbers. Nothing here is a typical figure.
If "left for the practice" is small or negative at a full caseload, change the model or the fee before you hire.
Entity and ownership rules
A group needs a company that can employ or contract clinicians, sign payer contracts and hold records. Which kind depends on your state. Some states steer licensed professionals to a PLLC or a professional corporation, limit ownership to licensees, and restrict ownership across different licenses. Our guide to PLLC vs LLC for therapists goes through New York, California, Illinois, Texas and North Carolina with links to each state source.
What changes when you grow from solo to group:
- Ownership.If a colleague will co-own, check that your entity type allows their license. Pre-licensed associates generally can't own any of it; in California an associate "shall have no proprietary interest in their employer's business."
- A co-owner agreement.Capital each owner puts in, who decides what, how profits are split, what happens if an owner leaves, becomes disabled or dies, and how the leaving owner is bought out. A lawyer drafts this.
- The practice name.A group name is usually a fictitious or assumed business name. California requires an LMFT who owns a business under a fictitious name to "inform the patient, prior to the commencement of treatment, of the name and license designation of the owner or owners of the practice" (BPC 4980.46). Check your board's naming rules before you pay for a logo.
- Identifiers.The company needs its own EIN and, if it bills insurance, a Type 2 NPI (see credentialing below).
- Insurance.Professional liability for the entity and for each clinician, general liability, and coverage for employment claims. Our liability insurance guide covers what to ask an insurer about group and supervision coverage.
- Taxes.Payroll changes how the company files and whether an S corporation election makes sense. Ask a CPA.
Supervising associates in a group
Hiring associates is how many groups grow, and it changes your role from colleague to supervisor with legal duties. Your board sets who can supervise, how many hours a week, how many supervisees one person can take, what has to be documented and whether video counts. Our clinical supervision guide has a supervision contract, note and log to copy, and covers direct and vicarious liability.
What a group owner adds to that:
- Clients have to be told.The ACA Code of Ethics says supervisees "disclose their status as supervisees and explain how this status affects the limits of confidentiality," and supervisors "ensure that clients are aware of the services rendered and the qualifications" of the supervisee (F.5.c, ACA Code of Ethics). California requires an associate to tell each client, before any services, that they're an unlicensed registered associate, with their registration number, their employer's name and whether they're supervised (BPC 4980.44(a)). Put it in your consent; our informed consent example has a supervisor line.
- Billing is narrower.Medicare enrolls marriage and family therapists and mental health counselors who are licensed in the state and have "at least 2 years or 3,000 hours of post master's degree clinical supervised experience" (CMS, MFTs and MHCs), so an associate can't bill Medicare. Commercial payers set their own rules for pre-licensed clinicians. Get each payer's policy in writing before an associate sees its members, and never bill an associate's session under a licensed clinician's NPI unless that payer's written policy allows it. Billing a federal program for claims "that you know or should know are false" is a False Claims Act problem (HHS OIG).
- Supervision is paid time.Your hours supervising are hours you don't bill. Put them in the worksheet above.
- The supervisor's coverage.Confirm your professional liability policy covers supervision.
Credentialing a group with insurance
If you take insurance, credentialing is often the slowest part of adding a clinician. Start it as soon as someone accepts an offer.
- Two kinds of NPI.Each clinician has a Type 1 NPI and keeps it: "Individuals are only eligible for one NPI." The practice gets a Type 2 NPI, the kind for "health care organizations, such as hospitals, nursing homes, and physician groups." Having an NPI doesn't mean a clinician is licensed or credentialed, that a plan will pay, or that anyone is enrolled in a health plan (CMS, NPI fact sheet).
- Commercial payers.They generally credential each clinician and link them to the group's contract. Ask each payer how it adds a clinician to your group contract, and don't book a plan's members with a new clinician until the payer confirms in writing that they're in network under your group.
- Medicare.Group practices enroll on Form CMS-855B. Each clinician enrolls and reassigns their benefits to the group, which is now done on Form CMS-855I; the old Form CMS-855R "has been discontinued" (CMS, Program Integrity Manual, chapter 10).
- Medicaid.Rules are state by state. Check your state Medicaid agency's provider enrollment pages.
- Exclusion checks.Federal programs make "no payment" for items or services "furnished, ordered, or prescribed by an excluded individual or entity," and anyone who hires someone on the List of Excluded Individuals/Entities "may be subject to civil monetary penalties" (HHS OIG, Exclusions background). Search the OIG exclusions list before every hire and on a regular schedule after.
- Self-pay clients.A group that sees self-pay clients still owes Good Faith Estimates, which list provider NPIs and tax IDs; our private practice startup guide covers the rule.
A log to keep one row per clinician per payer:
HIPAA for a group practice: policies, BAAs and training
If your practice sends claims or other standard transactions electronically, it is a HIPAA covered entity, and the group, not each clinician, holds the duties for work done there. Our guide to who HIPAA applies to sorts the common situations, including private-pay practices.
A solo therapist is the whole workforce. A group isn't, and that changes the work. HIPAA's workforce includes "employees, volunteers, trainees, and other persons whose conduct, in the performance of work for a covered entity or business associate, is under the direct control of such covered entity or business associate, whether or not they are paid" (45 CFR 160.103). Contractors working under your policies may be workforce rather than business associates; ask a lawyer which applies to yours.
What the rules require of a covered entity, in the order a new group usually builds them:
- Named officials. A privacy official and a contact for complaints (45 CFR 164.530(a)) and a security official (45 CFR 164.308(a)(2)). In a small group, the owner is often both.
- A risk analysis. "An accurate and thorough assessment of the potential risks and vulnerabilities" to electronic health information, then measures to reduce them (164.308(a)(1)). Redo it when you add people, offices or systems.
- Written policies. Policies "reasonably designed, taking into account the size and the type of activities" of your practice (164.530(i)), kept in writing and retained "for six years from the date of its creation or the date when it last was in effect, whichever is later" (164.530(j)).
- Training. Each new workforce member must be trained "within a reasonable period of time after the person joins," again when policies change materially, and the training must be documented (164.530(b)). The Security Rule adds security awareness training "for all members of its workforce (including management)" (164.308(a)(5)).
- Access by role. Policies so each person has "appropriate access" to electronic records, and procedures for "terminating access to electronic protected health information when the employment of, or other arrangement with, a workforce member ends" (164.308(a)(3) and (a)(4)).
- Sanctions. Apply "appropriate sanctions against members of its workforce" who break the policies, and document them (164.530(e)).
- Business Associate Agreements. A signed agreement with every vendor that creates, receives, maintains or transmits health information for you: your records system, booking and website, video, billing service, answering service, IT support and shredding.
- A notice of privacy practices in the group's name, and a complaint process (164.530(d)).
A checklist for the month you add your first clinician:
Real enforcement cases are a quick way to train new staff on what goes wrong; our HIPAA violation examples collects cases from therapy practices.
Hiring and onboarding your first clinician
Before you post the job
- Decide the role: license type, the clients they'll see, the states, the hours you need covered.
- Decide W-2 or 1099 with the check above, and the pay model with the worksheet.
- Ask your board about associate rules if the role is open to pre-licensed clinicians.
- Make sure you can carry the role's costs while their caseload fills.
Screening
- Verify the license on each state board's lookup, for every state they'll see clients in. Clinicians must be "licensed or legally permitted to practice in the state where the patient is located" (Telehealth.HHS.gov, Licensure for behavioral health); our counseling compact guide covers multistate options.
- Search the OIG exclusions list.
- Check references, including a past supervisor.
- Ask for their liability insurance certificate if they'll carry their own policy.
- In the interview, walk through an invented case vignette, including a risk question, to see how they think and how they document.
The clinician agreement
Have a lawyer draft or review it. Topics to cover:
Non-compete and non-solicitation rules are set by state law and vary widely; some states void most non-competes. Ask an employment lawyer what's enforceable where you practice, and remember the ethics codes below put the client's welfare and options first.
First week and first month
When someone leaves
Plan the ending on the first day. The NASW Code says social workers "who are leaving an employment setting should inform clients of appropriate options for the continuation of services and of the benefits and risks of the options" (1.17(f), NASW Code of Ethics). The APA Ethics Code asks psychologists entering employment or contracts to plan for "orderly and appropriate resolution of responsibility for client/patient care in the event that the employment or contractual relationship ends, with paramount consideration given to the welfare of the client/patient" (10.09, APA Ethics Code). The ACA Code asks counselors who transfer clients to make sure "appropriate clinical and administrative processes are completed" (A.11.d).
In practice: agree in advance who tells clients and how, what options they're offered, how records are handled, and when the departing clinician's access ends (the HIPAA termination step above). Who holds the records and for how long depends on your agreement and state record retention law; ask a lawyer.
A shared website and booking for several clinicians
A solo site answers one question: is this therapist right for me? A group site has to answer two: is this practice right for me, and which clinician should I see? Each clinician's page should carry:
- Name, license type and the states they can see clients in, since clients have to be in a state where the clinician can practice.
- What they treat and who they see (ages, couples, families), in plain words.
- Fees, and which insurance plans they're in network with under your group.
- Session types (video, in person, or both) and when they have openings.
- For associates, their status and supervision. In California, any advertisement by or for an associate MFT must include that they're a registered associate, their registration number, the employer's name and "that the person is supervised by a licensed person" (BPC 4980.44(b)), and the board defines advertising broadly. Treat a clinician page as an ad.
- A short bio in their own voice. Our therapist bio examples have ten to work from.
Then help visitors choose:
- A "not sure who to see?" path, such as a short consultation with whoever handles intake, so a visitor doesn't have to pick from ten faces.
- Filters that matter: state, insurance, specialty, video or in person, evening times.
- Booking per clinician, so a client books the person they chose, at times that person has opened.
- Paperwork before the first session: consent, telehealth consent and intake, under the group's name with the clinician's name filled in.
- No health details in a plain contact form. Ask only what you need to call back, and make sure any form, booking or chat vendor has signed a BAA.
Our therapist website examples show what working sites do well, and many of the same lessons apply to each clinician's page on a group site.
A 6-month plan to go from solo to group
A plan you can copy. It assumes one first hire; adjust the months to your state and payers.
Month 1: decide the model
- Pick a model: collective, contractors or employees.
- Run the W-2 or 1099 check for the role you have in mind.
- Book a lawyer and a CPA who work with health care practices.
- Ask your board about associate rules and supervision limits.
- Read your payer contracts for what they say about adding clinicians.
Month 2: set up the company
- Change or form the entity your state allows for a group.
- Get the group's EIN and Type 2 NPI if you'll bill insurance.
- Choose a payroll provider or contractor payment process.
- Update insurance for the entity, each clinician and supervision.
- Run the per-session worksheet with real numbers.
Month 3: build the systems
- Name the privacy and security officials, update the risk analysis and policies.
- Sign or update BAAs for every vendor.
- Rework the website for a group: practice page, clinician pages, booking per clinician.
- Write the clinician agreement with your lawyer.
- Write and post the job.
Month 4: hire
- Screen: licenses, exclusion check, references, a vignette interview.
- Make the offer and sign the agreement.
- Send credentialing applications the week they accept.
Month 5: onboard
- Work through the onboarding checklist.
- Train on HIPAA and record it.
- Start supervision if they're supervised.
- Open their booking hours for the clients they can see now (self-pay, or plans that have confirmed them).
Month 6: review
- Compare actual numbers with the worksheet: sessions held, collected per session, what's left for the practice.
- Ask the clinician what's working and what isn't.
- Check your own caseload and hours.
- Decide whether to hire again, and when.
The same plan as a block to paste into your notes:
How this works in TranqBay
TranqBay is practice software for therapists in private practice, built around one therapist's own practice. Its practice site describes plans for running your own practice and doesn't describe shared team features, such as one website listing several clinicians or a shared calendar. So if you're planning a group under one company, check what any software actually shows for groups before you plan around it.
Where TranqBay fits today:
- While you're still solo (months 1 to 3 of the plan). A practice website with designs made for therapy practices, and online booking so clients pick a time on your site. If you're turning away bookings you can't fit, that's the first sign from the readiness list.
- In a collective, where each clinician runs their own practice and keeps their own clients and records. Each therapist can have their own practice website and online booking.
- Video sessions that are end-to-end encrypted and HIPAA-ready. TranqBay provides a Business Associate Agreement that applies when you accept the Terms, with no separate document to sign. You can read the Business Associate Agreement and add it to your BAA log.
- Session notes in BIRP, DAP, SOAP or GIRP format, or a blank note. The structured formats are part of the advanced note templates, which some plans include.
- A form library of ready-made templates you send to a client for a session, including intake, consent to treat, telehealth consent, release of information, the PHQ-9 and the GAD-7. The client fills them in online and the answers wait with the session. TranqBay doesn't score them.
Look at a practice website template and the booking page your clients would use on practice.tranqbay.health before you decide what your own site needs, solo or as a collective.
Frequently asked questions about group private practice
What is a group private practice in therapy?
A practice where two or more clinicians see clients under one business, usually one name, one set of policies and often shared intake and billing. The owner employs or contracts the other clinicians. A collective, where each clinician runs their own practice and shares space, is a different arrangement even if it shares a name.
Group practice vs solo practice: which earns more?
It depends on your fees, your payers, what you pay clinicians and what running the group costs, including your own time away from sessions. A group can earn more than a solo practice, or less if margins are thin or caseloads fill slowly. Run the per-session worksheet with your numbers before you decide.
Can my group practice use 1099 contractors?
Sometimes, but the facts decide it, not the contract. If you set their schedule, assign their clients, train them in your methods and present them as your team, the IRS, Department of Labor and state tests may treat them as employees. Ask an employment lawyer and a CPA.
Can a pre-licensed associate be a 1099 contractor?
In California, no: associate MFTs, clinical social workers and professional clinical counselors may work only as employees or volunteers, and must show the board W-2s at licensure. Other states differ, so ask your board.
What does a 70/30 split mean in private practice?
One side gets 70 percent of what's collected for a clinician's sessions and the other gets 30 percent. Groups quote it both ways round, so check which side is the clinician's, and whether the split is on billed or collected money.
How many clinicians make a group practice?
There's no single legal number. Two clinicians practicing under one business is usually enough to call it a group, though payers and some laws define a group for their own purposes.
Do I need a new entity to start a group practice?
Not always, but check. Your current entity has to be one your state allows to employ or contract the licenses you plan to hire, and co-owners have to be eligible to own it. See our PLLC vs LLC guide.
Does each therapist in a group need their own NPI?
In practice, yes. Each clinician has their own Type 1 NPI, which payers need and Good Faith Estimates for self-pay clients list, and the practice gets a Type 2 NPI for the organization if it bills insurance.
Who keeps the client records when a therapist leaves?
Usually the practice holds them, but your agreement and state law decide it. Agree in writing before anyone starts: who holds records, how long they're kept, and how a departing clinician can get copies they need. Ask a lawyer.
Can a group practice be telehealth only?
Yes, with care for licensure: each clinician can see only clients located in states where they're licensed or legally permitted to practice. A telehealth group still needs every piece above: classification, pay rules, HIPAA, credentialing.
How long does it take to start a group practice?
The plan above uses six months for a first hire. Credentialing with insurance is often the slowest step, so self-pay groups can sometimes move faster.
Before you hire
Choose the model first, then run the W-2 or 1099 check and the per-session worksheet, and take both to a lawyer and a CPA before you sign anything. Copy the 6-month plan into your calendar and book the first two meetings this week.
While you're planning, make sure clients can already find and book you. See a practice website template and the online booking page on practice.tranqbay.health, with end-to-end encrypted video sessions, notes and forms behind it. If you're weighing whether to join, this page explains how joining TranqBay works. For the guides linked throughout, browse all our articles for therapists.
Sources
Federal 7States 8Regulations 5HHS 4CMS 3Associations 3socialworktoday.com 1
Other federal agencies7
- 1IRS: Independent contractor (self-employed) or employee?irs.govhttps://www.irs.gov/businesses/small-businesses-self-employed/independent-contractor-self-employed-or-employee
- 2IRS: Behavioral controlirs.govhttps://www.irs.gov/businesses/small-businesses-self-employed/behavioral-control
- 3IRS: Financial controlirs.govhttps://www.irs.gov/businesses/small-businesses-self-employed/financial-control
- 4IRS: Type of relationshipirs.govhttps://www.irs.gov/businesses/small-businesses-self-employed/type-of-relationship
- 5IRS: About Form SS-8irs.govhttps://www.irs.gov/forms-pubs/about-form-ss-8
- 6IRS: Voluntary Classification Settlement Programirs.govhttps://www.irs.gov/businesses/small-businesses-self-employed/voluntary-classification-settlement-program
- 7IRS: Instructions for Forms 1099-MISC and 1099-NECirs.govhttps://www.irs.gov/instructions/i1099mec
State boards and laws8
- 8U.S. Department of Labor: Misclassification of employees as independent contractorsdol.govhttps://www.dol.gov/agencies/whd/flsa/misclassification
- 9U.S. Department of Labor: Fact Sheet 13, Employment relationship under the FLSAdol.govhttps://www.dol.gov/agencies/whd/fact-sheets/13-flsa-employment-relationship
- 10U.S. Department of Labor: Fact Sheet 17D, Exemption for professional employeesdol.govhttps://www.dol.gov/agencies/whd/fact-sheets/17d-overtime-professional
- 11California Labor and Workforce Development Agency: ABC Testlabor.ca.govhttps://www.labor.ca.gov/employmentstatus/abctest/
- 12California Labor and Workforce Development Agency: Employment status FAQlabor.ca.govhttps://www.labor.ca.gov/employmentstatus/faq/
- 13California Board of Behavioral Sciences: Statutes and regulations, January 2026 (BPC 4980.43.3, 4980.44, 4980.46, 4996.23.2, 4999.46.3)bbs.ca.govhttps://www.bbs.ca.gov/pdf/publications/lawsregs.pdf
- 14USCIS: Form I-9, Employment Eligibility Verificationuscis.govhttps://www.uscis.gov/i-9
- 15Administration for Children and Families: New Hire Reportingacf.govhttps://acf.gov/css/employers/employer-responsibilities/new-hire-reporting
Laws and regulations5
- 1629 CFR 541.300: General rule for professional employeesecfr.govhttps://www.ecfr.gov/current/title-29/subtitle-B/chapter-V/subchapter-A/part-541/subpart-D/section-541.300
- 1729 CFR 541.605: Fee basisecfr.govhttps://www.ecfr.gov/current/title-29/subtitle-B/chapter-V/subchapter-A/part-541/subpart-G/section-541.605
- 1845 CFR 160.103: Definitionsecfr.govhttps://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-160/subpart-A/section-160.103
- 1945 CFR 164.308: Administrative safeguardsecfr.govhttps://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-C/section-164.308
- 2045 CFR 164.530: Administrative requirementsecfr.govhttps://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.530
U.S. Department of Health and Human Services4
- 21HHS OIG: Fraud and abuse lawsoig.hhs.govhttps://oig.hhs.gov/compliance/physician-education/fraud-abuse-laws/
- 22HHS OIG: Exclusions programoig.hhs.govhttps://oig.hhs.gov/exclusions/
- 23HHS OIG: Background information and exclusion authoritiesoig.hhs.govhttps://oig.hhs.gov/exclusions/background.asp
- 24Telehealth.HHS.gov: Licensure for behavioral healthtelehealth.hhs.govhttps://telehealth.hhs.gov/licensure/licensure-for-behavioral-health
Centers for Medicare & Medicaid Services3
- 25The National Provider Identifier (NPI) fact sheet, December 2024cms.govhttps://www.cms.gov/files/document/npi-fact-sheet.pdf
- 26Medicare Program Integrity Manual, chapter 10cms.govhttps://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/pim83c10.pdf
- 27Marriage and family therapists and mental health counselorscms.govhttps://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/marriage-family-therapists-mental-health-counselors
Professional associations3
- 28NASW Code of Ethics: Ethical responsibilities to clientssocialworkers.orghttps://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English/Social-Workers-Ethical-Responsibilities-to-Clients
- 29American Psychological Association: Ethical Principles of Psychologists and Code of Conductapa.orghttps://www.apa.org/ethics/code
- 30American Counseling Association: 2014 ACA Code of Ethicscounseling.orghttps://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf