Median revenue climbed to $80,412 in 2025, but expenses grew nearly as fast — and taxes remain the #1 business headache for private practice therapists nationwide

Heard, the financial management platform built for therapists in private practice, today released its fourth annual Financial State of Private Practice report. Based on self-reported survey data from nearly 2,000 mental health professionals across all 50 states and D.C., the report offers the most comprehensive look available at what therapists are earning, spending, and navigating on the business side of their practices.

Median revenue reached $80,412 in 2025, up from $68,222 the prior year. Two-thirds of respondents grew their revenue year-over-year, at a median growth rate of 10.6%. But expenses grew nearly as fast, rising 45% to a median of $18,000 annually. For solo practitioners — who make up 86.5% of respondents — median take-home profit was approximately $55,000.

"The story in the data this year is the gap between what therapists are earning and what they're keeping," said Andrew Riesen, Co-Founder and CEO of Heard. "Therapists are building growing businesses. But the financial infrastructure hasn't always kept pace. When we see that 53% are making quarterly tax payments while the other 47% aren't, and the profit difference between those two groups is nearly $30,000, that's a support problem. This report exists because therapists deserve the same financial clarity that any other small business owner would expect."

Other key findings from the 2026 report:

Taxes remain the most significant pain point, named by 53.6% of respondents as their number one business challenge. Therapists who paid all four quarters of estimated taxes reported median revenue of $95,455 and median profit of $66,978 — compared to $58,535 in revenue and $37,000 in profit for those who did not make any payments.

The typical therapist spends 10 hours per month on business administration. At a median clinical rate of $150 per hour, that represents up to $18,000 per year in potential revenue. One in three therapists still handles their own bookkeeping.

AI adoption has moved quickly. 66% of therapists now use AI tools in their practice, primarily for documentation and notes. Only 5% currently use AI for financial forecasting — a category Heard expects to grow.

The hybrid care model — a mix of telehealth and in-person sessions — generated the highest median profit of any care delivery format at $59,786, compared to $48,540 for telehealth-only and $54,272 for in-person-only practices.

Despite revenue growth, 62% of therapists have no plans to raise their fees in 2026. Among the 33.1% who did raise fees in 2025, median revenue was $94,792 — nearly $20,000 more than those who held their rates flat.

Read the full report here: https://rebrand.ly/financial_trend_businesswire

About Heard

Heard is a financial management platform built specifically for therapists in private practice. Heard combines bookkeeping, tax preparation, and financial insights so therapists can spend less time on financial administration and more time with clients.

View source version on businesswire.com: https://www.businesswire.com/news/home/20260422209298/en/

"The story in the data this year is the gap between what therapists are earning and what they're keeping."