Private Practice Accounting: Tax Questions for Therapists Answered with Andrew Riesen. (2024)

It’s tax season, which means private practice owners are likely googling how to file their taxes, what counts as a tax write-off, and wondering if they should hire accounting help. Today’s guest is Andrew Riesen. Andrew is a co-founder of Heard, an accounting and bookkeeping platform designed for private practice therapists. Prior to Heard, Andrew built a tax software startup for small businesses, worked as a financial accountant for PricewaterhouseCoopers, and spent time working at a wealth management firm.

This post and accompanying podcast are to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their attorney, business advisor, or tax advisor with respect to matters referenced in this post and podcast.

Bookkeeping for therapists and private practice accounting

First things first when you do bookkeeping as a therapist: make sure your business and personal finances are separate. That means no comingling of personal spending with business expenses. Keep your business bank account and related credit cards separate from your personal ones.

Make sure you have a place and method of tracking what money is coming in and what money is going out in your business (aka income and expenses). This could be as simple as an excel sheet (if you are organized and have a good system), or it could mean using free or low-cost software that helps you categorize your transactions and stay on top of bookkeeping such as Wave or Quickbooks. “Reconciling” is matching transactions on your bank statement and should be done at least monthly as a way to stay on top of your bookkeeping.

And, of course, pay your taxes in full and on time. In the U.S., small businesses pay quarterly estimated taxes and file taxes annually. Here’s a quick glance at important tax deadlines for small business owners in the U.S.

Quarterly Tax Filing Deadlines:

Annual Tax Filing Deadlines:

  • S Corporations - Due Date: March 15th

  • Sole Proprietors - Due Date: April 15th

Bookkeeping for private practice therapists

How long should a person spend on bookkeeping? In general, bookkeeping should take about an hour each month. In this amount of time, a clinician can reconcile and categorize their expenses, decide if their current expenses are worth it, and plan for the next month's income. In deciding if it's time to hire someone for bookkeeping or accounting, think about how much you as a therapist could earn in an hour, let's say $175, and if it takes you more than an hour to do your bookkeeping and accounting, it may be time to hire someone. At the time of this post/podcast, Heard charges $75/month for bookkeeping, quarterly tax estimates, annual tax filing, and accounting, so you'll be better spending your time seeing a client and hiring someone to help with bookkeeping and accounting.

How much should I pay myself as a therapist?

How much a person should pay themself varies. As a private practice therapist, at minimum, make sure you're setting aside money for federal and state taxes, retirement, business expenses, and your salary. I'm a fan of paying yourself 1-2x a month every month, rather than taking money from your business here-and-there when you feel like it.

An "entity" for your business means how your business is structured and what your business is called. These are often LLC, PLLC, or S-Corps. A "reasonable salary" is something you need to consider when you file paperwork to become an S-Corp. A clinician might want to "upgrade" from being an LLC or PLLC when their business grows to a point where they can benefit financially. A "reasonable salary" is state-specific and dependent on a person's profession. When a business is an S-Corp, they pay themselves a "reasonable salary" (taxed money) and can take owner distributions from their business that are not taxed. Becoming an S-Corp requires some paperwork but may be worth it depending on your business’ earnings.

What's the difference between a bookkeeper and an accountant?

A bookkeeper manages a businesses' books; they are looking at a businesses' income and expenses and reconciling expenses. They can also generate profit and loss statements. An accountant takes the information from bookkeeping to help planning ahead for the health of a business. A tax accountant has a specialized, niche skillset that focuses on how tax laws impact a business.

Why would a clinician use a tax accountant vs a tax lawyer?

A tax accountant can help with anything related to quarterly estimates, annual tax filings, and helping out with setting up an LLC/PLLC or filing paperwork to become a different business entity. A tax lawyer can help with the paperwork and legalities of setting up a partnership, say moving from an individual practitioner to a group practice. A good tax accountant will also refer you to a tax lawyer if they feel outside of the scope of their practice.

Why use Heard?

I mentioned on the podcast that I connected with Andrew and learned of Heard through another therapist friend, Dr. Marie Fang. Prior to finding Heard, I'd been shopping around for a new accountant. Why? Because while my accountant was ok, I felt like I was getting penalized anytime I had a question. Transparency and competence are important to me, and with all the new information (I recently changed my status from LLC to S-Corp and was looking for help with new PPP guidelines) I found myself pinging my accountant more than usual. But those questions often came with fees. I'd get my question answered, then get an invoice. I didn't like that feeling. I called around to several other small accounting firms and got the same answer: we can help you. It'll be $300-400 a month, and then another $1,500-2,500 to file your annual taxes.

It made no sense to me that as a small business owner with a relatively straightforward business model, that I'd need to spend several thousand dollars on bookkeeping and taxes.

When I found Heard I was relieved. For $149 a month, I'd get a dedicated expert, bookkeeping help, profit and loss statements, access to a human who I could ask all my questions (and not get penalized), tax estimates, annual tax filings, I literally couldn't sign up fast enough.

Plus, they specifically work with private practice owners because they believe in the importance of mental health clinicians having sound businesses. Because I appreciate their service so much, I'm an affiliate for them. I wouldn't be an affiliate for anything I didn't absolutely love and use. If you are looking for tax and bookkeeping help, I strongly recommend at least booking a consultation call with them.

Here’s more about their Heard’s services and pricing:

Heard’s services are bundled into a single price point of $149 per month or $1,341 (25% discount for annual payments), and include the following offerings:

Accounting Services:

  • Heard accounting platform

  • Customized set-up, implementation and training

  • Import of income and expenses to QuickBooks

  • Ongoing bookkeeping and accounting support

Tax Services:

  • Tax estimates and salary recommendations (four times a year)

  • Business income tax returns (federal and states)

  • Year-round advice to maximize tax savings

Additional Services:

  • Advice to set up Retirement Plans (Solo 401k, 401k, Roth IRA)

  • Payroll setup & ongoing payroll support through Gusto

  • Entity formation services – PLLC or LLC + S-Corp registration

Reach out to Heard to get help with your private practice accounting today!

Private Practice Accounting: Tax Questions for Therapists Answered with Andrew Riesen. (2024)

FAQs

Is tax accountant stressful? ›

Is it stressful to work as a Tax Accountant? Tax Accountants often face periods of high stress, particularly during tax season when workloads surge and deadlines loom. To manage this, effective time management and staying abreast of tax law changes are crucial.

What is the difference between practice and industry accounting? ›

Stability: Industry roles are generally more stable than practice roles, as you're working for a single company. Career progression: There are many opportunities for career progression in industry, and you can often move into more senior roles relatively quickly.

Is corporate accounting better than public? ›

Compared to a corporate finance setting, public accounting jobs can have the following disadvantages: Limited autonomy until reaching management or partner levels. Less depth in operational responsibilities for clients. More hours required in certain public accounting roles for tax or auditing.

Why is it advisable to consult an accountant when preparing taxes? ›

Tax professionals can advise you now and all year round on the best strategies to make smart tax-saving decisions. Your previous returns can be also reviewed. A tax professional can look at your past returns to see if any deductions were missed and, if so, amend them for you. You can reduce your risk of an audit.

What is the highest salary for a tax accountant? ›

How much does a Tax accountant make in India? The average tax accountant salary in India is ₹ 625,000 per year or ₹ 250 per hour. Entry-level positions start at ₹ 425,000 per year, while most experienced workers make up to ₹ 1,573,500 per year.

What is the most stressful job in the world? ›

Here are some examples of the most stressful career options:
  • Physician. National average salary: $272,872 per year Primary duties: Physicians or doctors are medical professionals who treat various diseases and injuries. ...
  • Nurse. ...
  • Soldier. ...
  • Patrol officer. ...
  • Anesthesiologist. ...
  • Chief executive officer. ...
  • Lawyer. ...
  • Police officer.

What are the Big 4 accounting practices? ›

These Big 4 are the four largest public accounting firms in the world:
  • Deloitte.
  • PricewaterhouseCoopers (PwC)
  • Ernst & Young.
  • KPMG.

What are the three main areas in the practice of the accountancy? ›

The accounting profession can be divided into three major categories: the practice of public accounting, private accounting and governmental accounting.

What are the three accounting practices? ›

The three types of accounting include cost, managerial, and financial accounting. ​​ Although 3 methods of accounting are both vital to the healthy functioning of a business, they have different meanings and accomplish different goals.

What is an example of a private accounting? ›

Private accountants may perform internal audits, verify billing, and set up internal accounting systems. They run accounts payable (AP), accounts receivable (AR), and general ledger (GL). They may work independently or oversee other employees, such as coworkers, bookkeepers, and accounting clerks.

What is the best industry for private accounting? ›

The top-paying industries for accountants include finance and insurance, management of companies and enterprises, tax preparation, and the government.

Do you make more money in public or private accounting? ›

Public accounting salaries are generally higher than private accounting salaries, although both fields are well compensated. The hiring outlook for both public and private accounting is strong. Candidates with three or more years of experience are in demand, but companies are also hiring new graduates.

Why do tax preparers get you more money? ›

A tax professional will dig deep into the tax code and uncover the deductions you're eligible for that can significantly lower your tax bill. Your tax preparer can also look at your returns and spending and make recommendations for adjustments you can make to your spending to make you more eligible for more deductions.

Is it better to file taxes yourself or by a professional? ›

If your income and filing status is about the same as last year and your return is relatively simple you'll probably be okay filing on your own. On the other hand, if you've gotten married, changed jobs or gotten a raise it might be wise to get professional help.

Is it better to use an accountant or TurboTax? ›

Choosing to work with a professional is better if you lack the time, patience and expertise with the ever-changing tax laws. You might consider outsourcing your taxes to an accountant if you believe the time you would have to devote to them would be better spent elsewhere.

Is taxation accounting hard? ›

Tax accounting can be perceived as challenging for several reasons: Complex Tax Laws: Tax regulations are intricate and subject to frequent changes. Understanding and staying updated on tax laws can be challenging, especially considering the nuances and variations across different jurisdictions.

Why is doing taxes so stressful? ›

As with most fear, it comes from the unknown. Because the taxes are being sent off to the government, a massive institution that has the power to oversee, audit, and take action against individuals for filing incorrect tax forms, the anxiety can seem quite real.

Is being a tax professional hard? ›

Becoming a tax preparer can be a rewarding job, but it also has its challenges. Sometimes, clients are difficult. Some of them will even lie and provide you with fraudulent information to include on a return.

Do tax accountants travel a lot? ›

Most accountants and auditors work in offices, but some work from home. Although accountants and auditors usually work in teams, some work alone. Accountants and auditors may travel to their clients' places of business.

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