The cheapest option this month is rarely the cheapest option over five years. For a therapist in New York, the long-term cost of running a practice comes from four places: money lost to unpaid claims, time lost to admin, platform fees that scale with your income, and the cost of rebuilding when a vendor changes. Here is how a fractional team at a flat rate changes that math.
1. Unpaid and under-paid claims
Industry data consistently shows that 5% to 10% of claims are denied on first submission, and a large share of denials are never worked. For a New York practice billing $150,000 a year, that is $7,500 to $15,000 a year leaking out. A dedicated biller who works denials and appeals recovers most of it. At $30 to $35 per hour, four hours a week pays for itself many times over.
2. Your own time
If you spend six hours a week on scheduling, insurance calls and paperwork, and your session rate is $150 to $200, that is $900 to $1,200 a week of clinical capacity you are giving away. Hand it to someone at $35 an hour and you have bought back up to $1,000 a week.
3. Fees that grow with you
Percentage-based billing and tiered platforms cost more as you grow. Over five years of a growing practice, a 6% billing fee on rising collections can cost $30,000 to $50,000 more than flat hourly support doing the same work.
4. The switching tax
Equity-backed vendors get acquired, raise prices or sunset products. Every migration costs you weeks. A clinician-owned partner that works inside your existing tools has nothing to migrate. If you leave, you simply remove our logins.
A simple five-year comparison
Solo practice growing from $120,000 to $200,000 a year in collections. Option A: percentage billing plus platform plus agency VA, roughly $150,000 over five years. Option B: MBBCS fractional team at 10 to 15 hours a week, roughly $85,000 to $120,000, with denials actually worked and your evenings back. The gap widens the faster you grow.
Quick answers
How much do unpaid claims cost a therapy practice?
Typically 5% to 10% of billed revenue is denied on first pass. Without follow-up, a practice billing $150,000 can lose $7,500 to $15,000 a year.
Is hourly support cheaper than percentage-based billing long term?
For a growing practice, yes. Hourly cost rises only when the work rises; percentage fees rise with every dollar you collect.
Can I start small and add hours later?
Yes. Many New York therapists start with 3 to 5 hours a week and grow the scope as their caseload grows.
Ready to talk? MBBCS is a clinician-owned practice management team in Brooklyn serving therapists across New York. Book a free 20-minute consult or get a ballpark estimate in 30 seconds.
