Most New York therapists cannot answer three questions about their own practice: What did I collect last month? What is still owed to me? What does one session actually cost me to deliver? Not because they are bad at business, but because nobody set up a simple way to see it. Here are the five numbers that matter, how to get them in under an hour a month, and what each one tells you.
1. Collections (not billed)
Money that actually hit your bank account this month. Billed revenue is a hope. Collections are reality. Pull it from your EHR or bank. If collections are more than 10% below billed for two months running, you have a denials or patient-balance problem.
2. Accounts receivable over 60 days
Claims and client balances older than 60 days. In a healthy solo practice this should be a small number. If it is growing, money is leaking. This is the number that tells you whether billing follow-up is happening.
3. Sessions delivered vs. sessions scheduled
Your real show rate. Below 85% means your cancellation policy is not being enforced or your scheduling has a structural problem (too many Friday 6 p.m. slots, for example).
4. Cost per session
Monthly overhead divided by sessions delivered. Rent, EHR, insurance, phone, software, directory fees, support. Knowing this number is what lets you set fees, sliding scale and panel decisions with confidence instead of guilt.
5. New inquiries and conversion
How many people contacted you this month, and how many became clients. If inquiries are high and conversion is low, the problem is response time or fit. If inquiries are low, the problem is marketing.
How to make this take an hour
One spreadsheet, five rows, updated on the first business day of the month. Collections and A/R from your EHR’s report. Show rate from the scheduling report. Inquiries from your email and Psychology Today. Overhead from your bank. MBBCS builds this dashboard for every New York practice we manage and sends the numbers monthly with a short note on what changed.
Why this matters more than it sounds
A therapist who knows these five numbers makes better decisions about panels, fees, hiring and time off, and sleeps better. A therapist who does not is guessing, usually in the direction of working more.
Quick answers
What financial metrics should a private practice therapist track?
Monthly collections, accounts receivable over 60 days, show rate, cost per session and new inquiries with conversion rate. Five numbers, once a month.
What is a healthy show rate for a therapy practice?
85% or higher. Below that usually points to an unenforced cancellation policy or scheduling structure problems.
How do I calculate cost per session?
Total monthly overhead (rent, EHR, insurance, software, support) divided by sessions actually delivered that month.
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.
