Practice Operations

If you have been wondering whether Medicare still reimburses virtual therapy visits, the direct answer is yes. Physical therapists (PTs), occupational therapists (OTs), speech-language pathologists (SLPs), and audiologists remain fully eligible to bill Medicare for Telehealth services through December 31, 2027. While political debates and temporary funding fights caused confusion early in the year, Congress officially resolved the status of therapy Telehealth. Here is what ha

It is one of the most frustrating notifications a private practice owner can receive. You submit a clean batch of claims, wait weeks for reimbursement, and instead open a Remittance Advice marked with a rejection code: Denied for Incorrect NPI. This specific rejection is incredibly common, yet completely avoidable. The most frustrating part is that an incorrect NPI claim denial often has absolutely nothing to do with you doing anything wrong clinically. Your NPI is real, your

It is the silent cash flow leak that every private practice owner deals with. You look at your schedule for the day, see a full lineup of five or six sessions, and plan your business revenue accordingly. Then, at 10:00 AM, a text arrives: "So sorry, something came up and I can't make it today." Two hours later, another client simply fails to log into the telehealth portal or show up at your office. Most therapists accept cancellations and no-shows as an inevitable, frustratin

When you first opened your private practice, your main goal was likely filling your schedule. To make that happen, you probably joined every insurance panel available in your area. Most therapists treat their panel list as a permanent setup: they take whatever insurance walks in the door and rarely look at their insurance contracts as a strategic business lever. But as your practice grows, taking every plan without a clear strategy can quietly cap your income. If you are work

It is a moment of total panic. You log into your billing portal or open the mail to find a notice from an insurance company stating you have been overpaid. They want their money back. To make matters worse, the notice is for claims you successfully processed and closed a year or more ago. If your stomach drops when you see these letters, you are not alone. This is happening constantly right now. Insurance audits and retrospective demands are skyrocketing across the mental hea

There is an exciting point in a therapy practice owner's career when the waitlist grows too long, demand outpaces your schedule, and you realize it is time to expand. You decide to transition from a solo setup to a group practice model by hiring your first associate or licensed clinician. Many practice owners assume that because they are already in-network with insurance panels, bringing a new therapist on board simply means handing them a client roster and billing under the

Let's skip the "follow your passion" intro and get to the numbers. Starting a therapy private practice is absolutely doable. But most first-year practices run into the same financial problems: costs that were higher than expected, revenue that arrived later than planned, and a few surprises nobody warned them about. This post breaks it all down. What you will actually spend, what tends to blindside people, and how the math changes depending on whether you are starting fresh o

You didn't spend years in clinical training to burn out inside a system that doesn't serve you. You've mastered your craft, cared for your patients, and navigated the institutional world. But the pull toward independence has become impossible to ignore. You want control over your schedule, your patient load, and your income. And you've decided: you're going to start a private practice in 90 days. The only thing standing in the way is the business side. The problem? Clinical t

If you run a small therapy practice, you’ve probably said (or heard): “We’re out of network, but we can give you a superbill and you can submit it to your insurance.” What that usually means in real life is: nobody really knows what will happen next, the patient is confused, and you’re crossing your fingers it somehow works out. What “Out-of-Network” Really Means When you are in network, you have signed a contract with the insurance company. They tell you exactly what they wi