Private Practice Break-Even Calculator

What is a private practice break-even point?

Your break-even point is the minimum number of billable sessions per month needed to cover your practice expenses. Below that number, you are losing money. Above it, every session adds to your take-home pay.

Most therapists starting private practice underestimate how few sessions it actually takes to break even. A solo virtual practice with $320/month in overhead and a $150 session fee breaks even at just 3 sessions per month. The question is not whether you can break even — it is how many sessions you need to hit the income goal that makes private practice worth it financially.

How the calculation works

The calculator uses three inputs to find your target caseload:

1. Session fee. If you see insurance clients, the calculator adjusts your effective rate downward. Most insurance panels reimburse around 30% less than your private pay rate. If you bill $150 private pay, insurance likely pays around $105.
2. Monthly overhead. This is every dollar your practice costs to run, regardless of how many clients you see. Rent, software, insurance, and professional fees.
3. Cancellation buffer. The calculator adds a 12% buffer on top of your target sessions. If you need 18 sessions per week, you should schedule 20 to account for no-shows, last-minute cancellations, and slow booking weeks. Most private practice therapists see a 10-15% cancellation rate.

What is a realistic private practice caseload?

Heard's 2025 Financial State of Private Practice report found the average solo practitioner sees clients for about 25 hours per week. At 46 working weeks per year (6 weeks off for holidays, illness, and vacation), that is approximately 1,150 billable sessions annually.

Most therapists find that 18-22 sessions per week is the sustainable range for long-term practice without burnout. Anything above 25 sessions consistently tends to degrade quality over time.

The session count that matters is not "how many you could see" but "how many you need to see to meet your financial goals at a pace you can sustain for years."

Insurance vs. private pay: the income gap

The insurance mix slider in this calculator matters more than most therapists realize. Private pay therapists earn an average of $159 per session. Insurance-panel therapists earn an average of $111 per session. That $48 gap means that at 20 sessions per week, a fully private pay therapist earns $46,080 more per year than an identical practice entirely on insurance.

Increasing your private pay percentage from 0% to 50% has the same effect on your effective hourly rate as raising your fee by $24 — without changing your listed session rate at all.