Taxes

The Multistate Tax Guide for Therapists

Headshot of Bryce Warnes
September 9, 2024
September 9, 2024
Bryce Warnes
Content Writer

If your practice treats clients in multiple states remotely, there is a good chance you will need to register your business in each state where your clients reside.

What’s more, you may be required to file income tax in those states, and pay income tax on the revenue you earn there.

Here’s what you need to know about cross-state tax requirements for your remote therapy practice, plus individual tax treatments for each state in the union.

Note: This guide is an overview of interstate income tax and income tax nexus for remote therapy practices. It’s a jumping-off point, not the last word on what’s right for your practice. Before making any major business decisions, consult with a CPA.

Does your therapy practice owe state income tax?

All but 9 states charge their residents income tax. What’s more, if you earn revenue in a state that does charge income tax, you may need to pay it—even if you never (physically) cross state lines. Each state has different criteria for who is required to pay income tax there. 

More on that in a moment. First, an important distinction: sales tax versus income tax.

Sales tax versus income tax for remote therapists

Sales tax and state income tax are two different taxes. 

Some states collect sales tax on retail sales. The good news is that no state in the USA charges sales tax on therapy services. So, regardless of which state you see clients in—remotely or otherwise—you do not need to collect and remit sales tax.

However, because so many companies sell products in different states, each state has laws requiring out-of-state businesses to collect and remit sales tax for sales they make in those states. 

The rapid growth of ecommerce in recent decades has caused quite a shakeup, as states scramble to ensure online retailers pay their due in sales tax. Google “sales tax nexus” to see just how complex some of these rules can be.

To be clear: sales tax is not income tax. Just because you meet the threshold set for paying sales tax in a particular state—$5,000 in sales within that state during the course of the year, for instance—does not mean you’re required to file and pay income tax there.

To make things more complicated, online resources often refer to the criteria for owing income tax as “nexus,” “tax nexus,” or “economic nexus.” What they’re really talking about is sales tax nexus, a set of rules established by a state determining who must collect and remit sales tax there.

The distinction is important, because while most state websites (and third parties) offer a wealth of information on sales tax nexus, clear information on income tax nexus is harder to come by.

This guide is all about figuring where your practice may trigger income tax nexus, and under what conditions. It has nothing to do with sales tax.

Corporate tax vs. individual income tax

Every state has laws for corporations operating within their bounds. Specifically, these laws have to do with corporate income tax.

When your business is a C corporation, you’re taxed on your income twice: First, your corporation pays income tax on its income. Then you as an individual pay income tax on any salary you earn from the corporation.

The following business structures do not qualify for corporate income tax:

These are so-called “pass-through” entities, meaning all taxes on income pass through to the partners or shareholders; they’re not individually taxed. 

Corporate tax law is a different beast altogether, and if your practice is at a stage of growth where it’s both incorporated as a C corporation and operating in multiple states, you’re beyond the scope of this article. It’s time to consult directly with your accountant on what to do next.

State income tax nexus for therapists

When your business is said to fall within a state’s income tax nexus, or “trigger” income tax nexus, that means you’ve conducted business activities there qualifying you—in the eyes of state tax authorities—to file and pay income tax in that state. 

The pertinent information is how much you earned in revenue in that particular state. Generally speaking, you’re only required to pay tax on the income you earn there. This is called apportionment.

For instance, if you earn 75% of your revenue seeing clients in your home state of California, and 25% seeing clients remotely in New York, tax authorities in New York expect you to pay taxes on that 25% of total revenue.

The rules about nexus vary considerably from state to state. In fact, some states don’t even use the term “nexus” in their official documents. But there have been attempts to universalize the way interstate commerce is treated.

The Interstate Income Act of 1959

Often referred to as Public Law 86-272 (P.L. 86-272), the Interstate Tax Act of 1959 specified that businesses were allowed to solicit sales in other states without being required to file and pay income tax in those states.

It’s a broad rule that’s still being reinterpreted as interstate commerce evolves. But how does it affect your practice?

Bottom line, when a state’s tax authority hasn’t put in place any alternative guidelines, P.L. 86-272 applies. Meaning it’s safe to assume that any revenue you earn treating clients in that state qualifies you for income tax. 

When states do have laws about income tax charges to foreign companies (“foreign” in this case just means “out-of-state”), they either:

  • Specify under what conditions foreign businesses fall within income tax nexus (e.g. sales thresholds, certain business activities); or
  • Use (often with modifications) the income tax factor presence nexus standard adopted by the Multistate Tax Commissioner (MTC) as a model statute.

The income tax factor presence nexus

The income tax factor presence nexus adopted by the MTC sets thresholds for out-of-state businesses. If your business crosses these thresholds, you’re liable for income tax.

The standard thresholds are:

  • $50,000 in property kept in the state
  • $50,000 in payroll paid in the state
  • $500,000 in sales earned in the state
  • 25% of total property, payroll, or sales in the state

Each state has made its own modifications to these thresholds.

The most important threshold to watch out for is 25% of sales. If you earn 25% or more of your revenue seeing clients in a particular state during the course of the year, and that state uses income tax factor presence nexus, then you’re liable to file and pay in that state.

How to know for sure whether you fall within income tax nexus

This article is meant as a guide to clear up your most pressing questions about seeing clients in different states. 

But laws are always changing. New states are always adopting and modifying the MTC nexus criteria, or putting in place their own laws. And it’s possible to miss some nuances without diving into state-level tax law. So, before making any serious decisions, contact state tax authorities directly, or talk to a qualified lawyer or accountant.

Registering for foreign qualification

When you register for foreign qualification in a particular state (also known as applying for a certificate of authority), you formally notify state tax authorities that you intend to do business there.

To foreign qualify in a state, you need to provide basic information about your business—such as its address, contact information for members or shareholders, and the name you’ll be doing business under.

In the eyes of the State, foreign qualification is important because it:

  1. Makes information about your business publicly available to residents of the state, who have a right to know which businesses are operating there; and
  2. Lets the State know you’re operating there, so they can subject you to the laws of the state and (if necessary) tax your business.

Foreign qualification is a multi-step process that may require you to request a Certificate of Good Standing from the state where your business is registered. 

You can get the full rundown from our article, How Do I Pay Taxes as a Therapist if I Have Clients in Multiple States?

Filing and paying taxes in multiple states

Each state has its own tax forms, online filing and payment portals, and processes for filing income tax. Rules also vary as to which businesses are required to pay taxes in quarterly estimated installments.

For more info, check out How to Pay Income Tax in Every State as a Therapist.

Therapist licensing in multiple states

This guide is concerned only with the tax implications of treating clients in multiple states. 

Getting licensed to practice psychotherapy in multiple states is a different matter. Before you can practice therapy in another state, you need to be licensed there, and how you do that varies according to the state.

There may be serious legal and professional repercussions for providing remote therapy in a state where you are not licensed. Before treating any out-of-state clients, get in touch with your local licensing board for more information.

In order to avoid applying for licenses in multiple states, you may choose to join an association that allows you to practice therapy across state lines. 

The Counseling Compact for therapists practicing in multiple states

The Counseling Compact, an initiative of the American Counseling Association, includes 37 member states. By joining the compact, you will be able to serve clients in any of those 37 states without applying for multiple state licenses.

The key phrase here is “will be able.” While the Compact is operational—meaning, 37 states have officially joined it—states have not begun granting members of the Compact legal rights to operate across state lines. The ACA projects that will start happening near the end of 2024.

Visit the Counseling Compact homepage to learn more about your eligibility and applying to become a member.

PSYPACT for therapists practicing in multiple states

If you have a doctoral degree, PSYPACT makes it easier to practice in multiple states. Administered by the Psychology Interjurisdictional Compact Commission, PSYPACT includes—as of 2024—42 states in total. Registering with PSYPACT allows you to practice in any of those states without registering for multiple licenses. 

Tax Guides for Every State:
Alabama Indiana Nebraska South Carolina
Alaska Iowa Nevada South Dakota*
Arizona Kansas New Hampshire Tennessee
Arkansas Kentucky New Jersey Texas
California Louisiana New Mexico Utah
Colorado Maine New York Vermont
Connecticut Maryland North Carolina Virginia
Delaware Massachusetts North Dakota Washington
Florida Michigan Ohio Washington, D.C.
Georgia Minnesota Oklahoma West Virginia
Hawaii Mississippi Oregon Wisconsin
Idaho Missouri Pennsylvania Wyoming
Illinois Montana Rhode Island

Paying taxes when you practice therapy in Alabama

If you practice remote therapy in Alabama while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Alabama

Alabama uses the factor presence nexus standard.

If your practice meets any of the following qualifications, you are legally required to file and pay state income tax in Alabama:

  • $54,000 of property located
  • $54,000 of payroll paid 
  • $538,000 of sales earned
  • 25% of total property, total payroll, or total sales

How to register for foreign qualification in Alabama

Registering for foreign qualification in Alabama is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Alabama are:

Time to complete registration Cost
One week $156

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Alaska

If you practice remote therapy in Alaska while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Alaska

Alaska does not collect state income tax, but you may still need to register with the State. Learn more about business licensing in Alaska.

How to register for foreign qualification in Alaska

Registering for foreign qualification in Alaska is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Alaska are:

Time to complete registration Cost
1 – 2 business days $350

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Arizona

If you practice remote therapy in Arizona while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Arizona

If your practice earned income by performing work in Arizona during the tax year, you fall within the income tax nexus for the state. 

For more info, see the Arizona Department of Revenue.

How to register for foreign qualification in Arizona

Registering for foreign qualification in Arizona is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Arizona are:

Time to complete registration Cost
10 – 14 business days $340
2 weeks $185
3 weeks $185

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Arkansas

If you practice remote therapy in Arkansas while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Arkansas

Arkansas does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Arkansas and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Arkansas

Registering for foreign qualification in Arkansas is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Arkansas are:

Time to complete registration Cost
One business day $270

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in California

If you practice remote therapy in California while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in California

California uses the factor presence nexus standard.

If your practice meets any of the following qualifications, you are legally required to file and pay state income tax in California:

  • $61,040 of property located there
  • $61,040 of compensation paid there
  • $610,395 of sales earned there 
  • 25% of total property, total compensation, or total sales there

How to register for foreign qualification in California

Registering for foreign qualification in California is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in California are:

Time to complete registration Cost
One business day $420
3 – 5 business days $70

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Colorado

If you practice remote therapy in Colorado while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Colorado

Colorado uses the factor presence nexus standard.

If your practice meets any of the following qualifications, you are legally required to file and pay state income tax in Colorado:

  • $50,000 of property located there
  • $50,000 of payroll paid there
  • $500,000 of sales earned there 
  • 25% of total property, total payroll, or total sales there

How to register for foreign qualification in Colorado

Registering for foreign qualification in Colorado is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Colorado are:

Time to complete registration Cost
One business day $100

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Connecticut

If you practice remote therapy in Connecticut while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Connecticut

Connecticut uses the factor presence nexus standard.

Connecticut applies a “bright-line” standard. If total receipts from practicing in the state  exceed $500,000 for the year, you have nexus there.

How to register for foreign qualification in Connecticut

Registering for foreign qualification in Connecticut is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Connecticut are:

Time to complete registration Cost
24 hours $170
1 – 2 business days $120
2 business days $325

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Delaware

If you practice remote therapy in Delaware while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Delaware

Delaware does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

Complete and submit the Delaware nexus questionnaire to determine whether you have nexus. 

How to register for foreign qualification in Delaware

Registering for foreign qualification in Delaware is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Delaware are:

Time to complete registration Cost
2 – 3 hours $1,200
One business day $700
1 – 2 business days $455
2 – 3 weeks $250

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Florida

If you practice remote therapy in Florida while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Florida

Florida does not collect state income tax, but you may still need to register with the State to practice there. For more information, see the Florida Department of Revenue.

How to register for foreign qualification in Florida

Registering for foreign qualification in Florida is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Florida are:

Time to complete registration Cost
2 days $280
2 – 3 weeks $125

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Georgia

If you practice remote therapy in Georgia while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Georgia

Georgia does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Georgia and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Georgia

Registering for foreign qualification in Georgia is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Georgia are:

Time to complete registration Cost
One to two days $475
3 - 5 business days $325

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Hawaii

If you practice remote therapy in Hawaii while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Hawaii

If your practice meets any of the following qualifications, you are legally required to file and pay state income tax in Hawaii:

  • Gross income of at least $100,000 from doing business in Hawaii

For more info, see the Hawaii Department of Taxation.

How to register for foreign qualification in Hawaii

Registering for foreign qualification in Hawaii is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Hawaii are:

Time to complete registration Cost
One week $76
3 weeks $51

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Idaho

If you practice remote therapy in Idaho while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Idaho

If your practice does any business in Idaho, you are legally required to file and pay state income tax there. 

For more information, see the Idaho State Tax Commission.

How to register for foreign qualification in Idaho

Registering for foreign qualification in Idaho is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Idaho are:

Time to complete registration Cost
One to two business days $145.20
7 – 10 business days $104

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Illinois

If you practice remote therapy in Illinois while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Illinois

If your practice does any business in Illinois, you are legally required to file and pay state income tax there. 

For more information, see the Illinois Department of Revenue.

How to register for foreign qualification in Illinois

Registering for foreign qualification in Illinois is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Illinois are:

Time to complete registration Cost
Up to 2 weeks $405
Up to 8 weeks $200

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Indiana

If you practice remote therapy in Indiana while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Indiana

If your practice does any business in Indiana, you are legally required to file and pay state income tax there. 

For more information, check out this article on Indiana Public Law 159.

How to register for foreign qualification in Indiana

Registering for foreign qualification in Indiana is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Indiana are:

Time to complete registration Cost
2 business days $107.36

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Iowa

If you practice remote therapy in Iowa while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Iowa

If your practice does any business in Iowa, you are legally required to file and pay state income tax there. 

For more information, see this 2020 update on Iowa nexus laws.

How to register for foreign qualification in Iowa

Registering for foreign qualification in Iowa is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Iowa are:

Time to complete registration Cost
One to two business days $100

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Kansas

If you practice remote therapy in Kansas while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Kansas

Kansas does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Kansas and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Kansas

Registering for foreign qualification in Kansas is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Kansas are:

Time to complete registration Cost
2 – 3 weeks $165

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Kentucky

If you practice remote therapy in Kentucky while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Kentucky

Members of foreign pass-through entities (including LLCs filing as S corporations) must file and pay state income tax on their shares of revenues.

Meaning, if your practice earns income in Kentucky, you will likely be required to file an income tax return there. For more info, see the Kentucky Department of Revenue.

How to register for foreign qualification in Kentucky

Registering for foreign qualification in Kentucky is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Kentucky are:

Time to complete registration Cost
One to two business days $90

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Louisiana

If you practice remote therapy in Louisiana while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Louisiana

Louisiana does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Louisiana and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Louisiana

Registering for foreign qualification in Louisiana is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Louisiana are:

Time to complete registration Cost
One business day $205

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Maine

If you practice remote therapy in Maine while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Maine

If you earn income treating clients located in Maine, there is a strong chance you must file and pay income tax in that state.

For more information, see the Maine Bureau of Revenue Services, Rule 801.

How to register for foreign qualification in Maine

Registering for foreign qualification in Maine is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Maine are:

Time to complete registration Cost
4 – 6 business days $505
2 – 3 months $250

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Maryland

If you practice remote therapy in Maryland while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Maryland

Maryland does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Maryland and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Maryland

Registering for foreign qualification in Maryland is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Maryland are:

Time to complete registration Cost
One to two business days $154.50

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Massachusetts

If you practice remote therapy in Massachusetts while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Massachusetts

Maryland does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Massachusetts and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Massachusetts

Registering for foreign qualification in Massachusetts is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Massachusetts are:

Time to complete registration Cost
2 business days $520

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Michigan

If you practice remote therapy in Michigan while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Michigan

Based on rules set by Michigan’s Department of Treasury, it’s unlikely your therapy practice will trigger nexus if you see clients remotely. 

You can learn more from the Michigan Department of Treasury.

How to register for foreign qualification in Michigan

Registering for foreign qualification in Michigan is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Michigan are:

Time to complete registration Cost
1 – 2 business days $150
2 – 3 business days $100
One to two weeks $50

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Minnesota

If you practice remote therapy in Minnesota while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Minnesota

If your practice treats clients in Minnesota, it’s likely you fall within the income tax nexus for the state. You can learn more from Minnesota Employment and Economic Development.

If you’re not sure about your status, contact the Minnesota Department of Revenue directly.

How to register for foreign qualification in Minnesota

Registering for foreign qualification in Minnesota is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Minnesota are:

Time to complete registration Cost
One business day $205

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Mississippi

If you practice remote therapy in Mississippi while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Mississippi

According to Mississippi Income Tax Regulation Title 35 Part III Subpart 08 Chapter 06, if your therapy practice treats a client remotely on an ongoing basis, you likely qualify to file and pay income tax in the state.

How to register for foreign qualification in Mississippi

Registering for foreign qualification in Mississippi is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Mississippi are:

Time to complete registration Cost
One business day $257.54

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Missouri

If you practice remote therapy in Missouri while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Missouri

Missouri does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Missouri and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Missouri

Registering for foreign qualification in Missouri is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Missouri are:

Time to complete registration Cost
One to two weeks $107.35
Two business days $280

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Montana

If you practice remote therapy in Montana while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Montana

If your therapy practice regularly treats clients in Montana, there’s a strong chance you are required to file and pay income tax in the state. 

In order to be certain, you should complete and submit the Montana Department of Revenue Nexus Questionnaire.

How to register for foreign qualification in Montana

Registering for foreign qualification in Montana is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Montana are:

Time to complete registration Cost
One business day $170
One to two business days $70

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Nebraska

If you practice remote therapy in Nebraska while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Nebraska

Nebraska does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Nebraska and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Nebraska

Registering for foreign qualification in Nebraska is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Nebraska are:

Time to complete registration Cost
3 – 4 business days $113.30

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Nevada

If you practice remote therapy in Nevada while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Nevada

Nevada does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in Nevada

Registering for foreign qualification in Nevada is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Nevada are:

Time to complete registration Cost
One business day $76.88

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in New Hampshire

If you practice remote therapy in New Hampshire while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in New Hampshire

Nevada does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in New Hampshire

Registering for foreign qualification in New Hampshire is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in New Hampshire are:

Time to complete registration Cost
2 – 3 business days $105

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in New Jersey

If you practice remote therapy in New Jersey while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in New Jersey

Because of relatively recent changes in the way New Jersey handles nexus for foreign businesses, it may be difficult to determine obligations for your therapy practice. Contact the New Jersey Division of Taxation for more information.

How to register for foreign qualification in New Jersey

Registering for foreign qualification in New Jersey is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in New Jersey are:

Time to complete registration Cost
One business day $143.50

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in New Mexico

If you practice remote therapy in New Mexico while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in New Mexico

If you treat clients in New Mexico, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in New Mexico

Registering for foreign qualification in New Mexico is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in New Mexico are:

Time to complete registration Cost
6 – 8 weeks $100

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in New York

If you practice remote therapy in New York while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in New York

If you treat clients in New York, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in New York

Registering for foreign qualification in New York is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in New York are:

Time to complete registration Cost
One to two business days $490
One week $280

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in North Carolina

If you practice remote therapy in North Carolina while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in North Carolina

If you treat clients in North Carolina, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in North Carolina

Registering for foreign qualification in North Carolina is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in North Carolina are:

Time to complete registration Cost
One to two business days $453
3 – 5 business days $353
2 – 3 weeks $253

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in North Dakota

If you practice remote therapy in North Dakota while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in North Dakota

If you treat clients in North Dakota, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in North Dakota

Registering for foreign qualification in North Dakota is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in North Dakota are:

Time to complete registration Cost
One to three business days $135

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Ohio

If you practice remote therapy in Ohio while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Ohio

Ohio uses the factor presence nexus standard.

If your practice meets any of the following qualifications, you are legally required to file and pay state income tax in Ohio:

  • $50,000 of property located there
  • $50,000 of payroll paid there
  • $500,000 of sales earned there 
  • 25% of total property, total payroll, or total sales there

How to register for foreign qualification in Ohio

Registering for foreign qualification in Ohio is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Ohio are:

Time to complete registration Cost
2 – 3 business days $99

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Oklahoma

If you practice remote therapy in Oklahoma while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Oklahoma

If you treat clients in North Dakota, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in Oklahoma

Registering for foreign qualification in Oklahoma is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Oklahoma are:

Time to complete registration Cost
2 business days $312

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Oregon

If you practice remote therapy in Oregon while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Oregon

If you treat clients in North Dakota, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in Oregon

Registering for foreign qualification in Oregon is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Oregon are:

Time to complete registration Cost
One to two business days $525
2 weeks $275

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Pennsylvania

If you practice remote therapy in Pennsylvania while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Pennsylvania

Pennsylvania does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in Pennsylvania and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Pennsylvania

Registering for foreign qualification in Pennsylvania is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Pennsylvania are:

Time to complete registration Cost
One to two business days $525
3 weeks $250

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Rhode Island

If you practice remote therapy in Rhode Island while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Rhode Island

If you treat clients in Rhode Island, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in Rhode Island

Registering for foreign qualification in Rhode Island is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Rhode Island are:

Time to complete registration Cost
One to two business days $305
3 – 5 business days $156

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in South Carolina

If you practice remote therapy in South Carolina while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in South Carolina

If you treat clients in South Carolina, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in South Carolina

Registering for foreign qualification in South Carolina is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in South Carolina are:

Time to complete registration Cost
One to two business days $285
One week $125

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in South Dakota

If you practice remote therapy in South Dakota while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in South Dakota

South Dakota does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in South Dakota

Registering for foreign qualification in South Dakota is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in South Dakota are:

Time to complete registration Cost
One to two business days $775

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Tennessee

If you practice remote therapy in Tennessee while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Tennessee

Tennessee does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in Tennessee

Registering for foreign qualification in Tennessee is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Tennessee are:

Time to complete registration Cost
2 – 3 weeks $50 per member of the LLC, with a minimum fee of $300

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Texas

If you practice remote therapy in Texas while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Texas

Texas does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in Texas

Registering for foreign qualification in Texas is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Texas are:

Time to complete registration Cost
One week $750

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Utah

If you practice remote therapy in Utah while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Utah

If you treat clients in Utah, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in Utah

Registering for foreign qualification in Utah is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Utah are:

Time to complete registration Cost
2 business days $154
3 weeks $54

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Vermont

If you practice remote therapy in Vermont while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Vermont

If you treat clients in Vermont, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in Vermont

Registering for foreign qualification in Vermont is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Vermont are:

Time to complete registration Cost
One business day $125

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Virginia

If you practice remote therapy in Virgina while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Virginia

If you treat clients in Virginia, you most likely trigger nexus in the state, meaning you are required to file and pay income tax there.

How to register for foreign qualification in Virginia

Registering for foreign qualification in Virginia is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Virginia are:

Time to complete registration Cost
3 – 4 business days $355
One to two weeks $100

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Washington

If you practice remote therapy in Washington while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Washington

Washington does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in Washington

Registering for foreign qualification in Washington is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Washington are:

Time to complete registration Cost
2 – 3 business days $435
One week $200

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Washington, D.C.

If you practice remote therapy in the District of Columbia while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Washington, D.C.

D.C. does not provide hard-and-fast rules for determining income tax nexus if you are a remote therapist.

However, based on the MTC’s most recent interpretations of P.L. 86-272 (the Interstate Income Act of 1959), if you serve therapy clients in D.C. and earn revenue by doing so, you likely owe state income tax on those earnings. For more information, consult with a CPA or commercial lawyer familiar with the local tax code. 

How to register for foreign qualification in Washington, D.C.

Registering for foreign qualification in the District of Columbia is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in the District of Columbia are:

Time to complete registration Cost
2 business days $320
One week $270
2 – 3 business weeks $220

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in West Virginia

If you practice remote therapy in West Virginia while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in West Virginia

If your practice treats clients in West Virginia, there is a strong chance you are required to file and pay income tax there. For more information, see the West Virginia State Tax Department Questionnaire.

How to register for foreign qualification in West Virginia

Registering for foreign qualification in West Virginia is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in West Virginia are:

Time to complete registration Cost
2 business days $305
One week $150

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Wisconsin

If you practice remote therapy in Wisconsin while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Wisconsin

If your practice treats clients in Wisconsin, there is a strong chance you are required to file and pay income tax there. For more information, see the Wisconsin Nexus Questionnaire.

How to register for foreign qualification in Wisconsin

Registering for foreign qualification in Wisconsin is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Wisconsin are:

Time to complete registration Cost
One to two business days $100

To complete your application and pay associated fees, visit:

Paying taxes when you practice therapy in Wyoming

If you practice remote therapy in Wyoming while your practice is based in a different state, here’s what you need to know.

Income tax nexus triggers and thresholds in Wyoming

Wyoming does not collect state income tax, but you may still need to register for foreign qualification to practice there.

How to register for foreign qualification in Wyoming

Registering for foreign qualification in Wyoming is the easiest way to practice there legally. 

The time required and the cost to register your LLC for foreign qualification in Wyoming are:

Time to complete registration Cost
2 – 3 weeks $150

To complete your application and pay associated fees, visit:

‍Not sure how or where to make state income tax payments? Check out our guide on how to pay income tax in every state as a therapist

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

Bryce Warnes is a West Coast writer specializing in small business finances.

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Run your therapy practice with confidence

Run your therapy practice with confidence

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