The Heard 2026 Financial State of Private Practice Report

The Heard 2026 Financial State of Private Practice Report

For the fourth year in a row, we surveyed therapists nationwide to better understand the state of private practice finances in the United States today.

For the fourth year in a row, we surveyed therapists nationwide to better understand the state of private practice finances in the United States today.

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What nearly 2,000 therapists told us about running a practice

The largest survey of its kind

We asked nearly 2,000 therapists and wellness practitioners across all 50 states about their earnings, expenses, and the challenges they face.

Four years of data

This is Heard's fourth annual report. You can see how private practice finances are actually shifting — and where the field is heading.

A source you can trust

Heard manages bookkeeping and taxes for thousands of therapists. This data comes from real practices — not estimates or national averages.

Get the 2026 Financial State of Private Practice Report

See what therapists across the country are earning, spending, and building.

Median private practice revenue reached $80,412 in 2025 — up 18% from the year before.

2025 median revenue
$80,412
up from $68,222 in 2024
2024 median revenue
$68,222

53.6% of therapists named taxes their #1 business challenge — well ahead of everything else.

53.6%
cite taxes and quarterly payments as their top challenge
Taxes & quarterly payments
54%
Keeping finances organized
49%
Insurance billing and claims
38%
Bookkeeping
34%

Insurance-accepting therapists earned about 30% less per session than those on private pay.

~$105
avg. insurance reimbursement in 2025
~$150
avg. private pay rate in 2025

Only 33% of therapists raised their fees in 2025. Expenses jumped 45% that same year.

33.1% of therapists raised their fees in 2025
+45% jump in median business expenses year-over-year

Explore free articles, guides, and tools to help you understand and manage your therapy practice finances.

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Heard is the only financial management software built for therapists that enables you to manage your bookkeeping, taxes, and payroll—all in one place.

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