For the second 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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The 2024 Financial State of Private Practice Report features more information about insurance reimbursement rates, business structures, and student loan debt than last year’s report.

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We also drilled down to collect more data about how much therapists charge, how much they earn, and what it costs to stay in business.

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On top of that, in 2024, over 2,000 private practice therapists completed the survey. That’s up from just over 1,200 in 2023.

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When you’re a self-employed therapist, it can sometimes feel as though you’re on your own, making your way in a profession that’s ever-evolving and—at least when it comes to finance and business matters—under documented. 

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We hope this survey will go some small way towards changing that.

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A few takeaways from the report.

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More school doesn’t mean more money

Of survey respondents holding Master’s and Doctorate degrees, 89% made under $100,000 in profits last year.

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At the same time, 25% of therapists with student loan debt reported owing in excess of $100,000.

Expenses are rising, and fees aren’t keeping up

More than half of respondents said their business expenses increased last year, but only 34% of respondents said they raised their fees in 2023.

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In last year’s report, over 60% of respondents said they planned to raise fees in 2023. 

Insurance reimbursement rates are low

While the average session fee for individual therapy in 2023 was $157, the average reimbursement rate by insurance companies was just $122 per session. 

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That means the average in-network client pays out 25% less than an out-of-network client.

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In total, 73% of respondents accepted some type of insurance.

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Economic anxiety is high

Therapists are anxious about the future. Eighty-three percent said they were worried about the economy.

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That being said, about the same percentage reported economic anxiety in last year’s report. So if rising inflation and interest rates in 2023 had a role to play, it’s unclear to what degree.

Therapists put clients over profits

Generally, therapists responding to both last year’s and this year’s survey reported taking measures to make sure their services remained accessible to clients. 

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Both years, about three quarter of therapists reported offering sliding scale fees and pro bono sessions. Even with a tough economic landscape and fears about the future, therapists in private practice are putting in the hard work to make sure clients get the treatment they need.

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