Your caseload is full, you have a waitlist, and you are starting to wonder about bringing on another clinician. Going from solo to group practice in New York is a business decision more than a clinical one, and the order you do things in matters. Here is the sequence we recommend, based on building a multi-location group practice in Brooklyn.
Signs you are ready
- A consistent waitlist or referrals you are turning away every month.
- Your own schedule has been full for six months or more.
- Your systems (scheduling, billing, documentation) run without you touching them daily.
- You have three to six months of operating cash set aside.
If the third point is not true yet, fix that first. Adding a clinician to a practice with messy systems multiplies the mess.
Step 1: Decide W-2 versus 1099
New York State scrutinizes independent contractor classification closely. If you set the clinician’s schedule, provide the office and EHR, and control how they work, they are very likely an employee. Most New York group practices use W-2 employees or a carefully structured 1099 arrangement reviewed by an employment attorney. Get this right before the first hire.
Step 2: Set up payroll, workers’ comp and disability
New York requires workers’ compensation, disability and Paid Family Leave coverage for employees. Set up payroll (Gusto and similar tools are common), register with the Department of Labor, and build your paid time off policy.
Step 3: Credential the new clinician
Start credentialing the day you sign the offer. Sixty to 120 days per panel means a clinician who starts before paneling is done is seeing self-pay only, or billing under supervision rules where allowed.
Step 4: Write the onboarding system once
Employment agreement, clinical documentation standards, supervision schedule if applicable, EHR access and training, marketing profile setup, and a 30-60-90 day plan. Write it as a checklist so the second hire is easier than the first.
Step 5: Fill their caseload
A new clinician with an empty schedule costs you money every week. Marketing, referral outreach and intake routing should be running before their start date.
Where MBBCS fits
We handle steps 2 through 5 for New York group practices at $30 to $35 per hour: payroll setup and HR documentation, credentialing, onboarding systems, and the marketing to keep every seat full. Your attorney handles step 1; we work alongside them.
Quick answers
Should I hire W-2 or 1099 therapists in New York?
New York applies a strict test. If you control schedule, location and method, the clinician is likely an employee. Most New York group practices use W-2 or an attorney-reviewed 1099 structure.
How much cash should I have before hiring a clinician?
Three to six months of operating expenses, because credentialing and caseload ramp-up take 60 to 120 days.
Can MBBCS help me expand to a group practice?
Yes. We handle payroll setup, HR documentation, credentialing, onboarding systems and marketing for New York group practices, and our team runs one.
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.
