Starting and scaling your own therapy practice

Deciding to start your own therapy practice is no small feat. It comes with excitement, ambition, and uncertainty around business details that aren’t typically covered in clinical training. You’re skilled and passionate about helping your clients, but navigating everything from legal structures to marketing can feel like a whole new world. 

The most successful therapists emphasize that strong preparation and the right support network lay the foundation for growth. Let’s break down the journey into manageable steps for getting started and fueling ongoing growth. 

Quiz: Have you taken the first steps? 

Check your readiness by answering these quick questions. They’re designed to highlight the first key steps in building a stable practice foundation – the essentials that support everything that follows. 

Have you written a mission statement? 

This is your practice’s guiding star. It defines your purpose and helps you make decisions that align with your core values. 

(A) Yes, it’s clear and I use it to guide my plans. 

(B) I have a sense of it but it’s not quite on paper. 

(C) Not yet, but I want to! 

Do you know which business structure is right for you? 
Your business structure (e.g., LLC, Sole Proprietorship) affects your taxes and legal liability. It’s a key decision for protecting your personal assets. 

(A) Yes, I’ve researched and chosen what fits. 

(B) I’m still weighing my options. 

(C) I haven’t started looking into this. 

Have you researched local licensing requirements? 

Beyond your clinical license, your city or state may require specific business permits to operate legally. 

(A) Yes, I know what my state/city requires. 

(B) I’m collecting information now. 

(C) Not yet, but I know it’s important. 

Are you aware of insurance credentialing? 

If you plan to accept insurance, you must be credentialed with each payer. This process proves you are a qualified provider. 

(A) Yes, and I’ve started the process or have a plan. 

(B) I understand the basics but haven’t begun. 

(C) I’ve yet to explore this area. 

If you answered mostly (A)s: You’re well on your way! You have a solid plan and are tackling the essential first steps. For more advanced strategies on scaling and growth, feel free to jump ahead and download our comprehensive eBook. 

If you answered mostly (B)s: You’re making great progress! Your next step is to turn those plans into concrete actions. Focus on finalizing your legal and operational foundations (we cover this in the next section). 

If you answered mostly (C)s: You’re in the right place! This is the perfect time to start planning. Let’s build your foundation together, one step at a time. 

Creating your foundation 

Taking your practice from an idea to a reality is much less overwhelming when you break it down into focused stages. Here’s how you can build a strong foundation and set yourself up for future growth. 

1. Set up your legal and financial basics 

Getting the administrative groundwork right from the start prevents major headaches down the road. This phase is all about creating the official structure of your practice. 

• Choose a business structure. This is one of your first big decisions. The most common options are Sole Proprietorship, Limited Liability Company (LLC), or a Corporation. Many therapists choose an LLC because it offers a good balance of liability protection and operational simplicity. To learn more about what might be right for you, the U.S. Small Business Administration offers a helpful guide. 

• Obtain licenses and permits. Your professional license is just the start. Your state and city have their own rules for operating a business. Research your local government’s website to find out if you need a general business license or specific health facility permits. 

• Get your National Provider Identifier (NPI). If you plan to bill insurance, you’ll need an NPI. It’s a unique 10-digit identification number for healthcare providers. You can apply for free through the National Plan & Provider Enumeration System (NPPES). The application is straightforward, and approval is usually quick. 

• Start the credentialing process. Becoming an in-network provider for insurance companies requires credentialing. This process can take anywhere from 60 to 180 days, so it’s critical to start early. You’ll need to submit documents like your license, proof of liability insurance, and your NPI to each insurance panel you want to join. 

• Open a business bank account. It is crucial to keep your business and personal finances separate. Opening a dedicated business bank account simplifies bookkeeping, makes tax season easier, and gives you a clear picture of your practice’s financial health. 

2. Prepare your practice space 

Whether it’s a physical office or a virtual setup, your practice space is a key part of the client experience. 

For a physical location, prioritize accessibility. An ADA-compliant space with ramps and accessible restrooms ensures you can serve everyone in your community. For telehealth, a successful virtual practice relies on professionalism and security. Choose a HIPAA-compliant platform and set up a quiet, private workspace with a stable internet connection. 

3. Streamline your operations 

Efficient operations are the key to a practice that runs in harmony. When your daily administrative tasks are simplified, you have more time and energy to focus on your clients. 

• Choose the right EMR. A good Electronic Medical Record (EMR) system can do more than just store notes. An EHR designed for your specialty, like rehab or ABA therapy, will have features for faster documentation, intelligent scheduling, integrated billing and reporting, etc.  

• Master your billing. Billing is a common source of stress for practice owners. A reliable system for creating claims and managing payments is essential. For those who want to offload the complexity, revenue cycle management (RCM) services can handle insurance claims and denials, ensuring a healthier cash flow. 

Grow and scale with purpose 

Once your foundation is solid, it’s time to attract clients and build your reputation. As you move from starting up to scaling up, these strategies can help you expand your impact. 

• Build an online presence. A professional website is your digital front door. Make it easy for potential clients to learn about your services and book an appointment. Listing your practice in online directories like Google My Business also helps local clients find you. For more on this, check out our guide on Five ways to build online trust, visibility, and engagement for your practice. 

• Network intentionally. Connect with other healthcare providers, schools, and community groups. Building relationships with other professionals who serve similar client populations can be a great source of referrals. If reaching out feels uncomfortable, check out our newsletter post on Growing your practice without selling. 

• Automate and delegate. As you grow, your time becomes your most valuable asset. Use technology to automate routine processes, and consider hiring administrative support to handle non-clinical tasks so you can focus on client care and business strategy. 

• Invest in your team. If you decide to hire, finding people who align with your mission is key. A positive team culture benefits everyone. Support your staff with professional development opportunities and create open lines of communication. 

Your next step 

Your practice’s growth will look different from anyone else’s, and that’s a good thing. With strong foundations, streamlined systems, and an openness to adapt, you’ll be able to support more clients and create a career that reflects your vision for care and teamwork. 

If you want deeper, step-by-step guidance, download our eBook, From vision to practice, for a more comprehensive roadmap. 

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Disclaimer: This article is for educational purposes only and does not constitute legal, financial, or tax advice. Please consult qualified professionals for guidance specific to your situation