Let’s get straight to the point: we’re probably cheaper than you think.
Most therapists assume hiring a real CPA firm is going to cost them a fortune. So they either go with accounting software like Heard, try to DIY it with QuickBooks, or hire a generic bookkeeper who doesn’t understand therapy practices.
Here’s what actually happens: you pay less upfront and end up paying way more in missed deductions, tax penalties, and time you can’t get back.
We charge $250-$450 per month for full-service accounting. That includes monthly bookkeeping, year-round tax strategy, and actual CPAs who specialize in therapy practices.
Why We’re Talking About Heard Specifically
You’ve probably seen ads for Heard. They market heavily to therapists, and on the surface, it looks appealing.
But here’s what you need to understand: Heard is accounting software, not a CPA firm.
Yes, they offer some tax support. Yes, they have CPAs available. But their core product is software that connects to your bank accounts and categorizes transactions. The CPA support is limited, reactive, and not included in their base pricing.
When you work with us, you’re working with actual CPAs from day one. We’re doing your bookkeeping, planning your tax strategy proactively throughout the year, and we actually know the financial realities of running a therapy practice.
We wrote an entire breakdown comparing TLDR Accounting versus Heard for therapists if you want all the details.
But the short version is this: software can’t give you a proactive tax strategy, and it can’t spot the expensive mistakes before they happen.
Here’s What You Actually Get For $250-$450/Month
Let’s break down what full-service accounting actually means, because this is where the difference between software and a real CPA firm becomes obvious.
Monthly bookkeeping: We categorize every transaction, reconcile your accounts, and make sure your books are accurate. This isn’t automated software categorization that gets things wrong half the time. These are actual humans who understand therapy practice finances, looking at your numbers every single month.
Year-round tax strategy: We don’t just file your taxes in April and disappear. We’re actively planning throughout the year to minimize what you owe. Should you buy that new office furniture in December or January? Should you prepay expenses? When does an S-Corp election make sense? We’re answering these questions in real-time, not after the fact.
Quarterly tax calculations: We calculate your estimated payments based on your actual income and the timing quirks of insurance reimbursements. You’re not guessing or using last year’s numbers. You’re paying the right amount at the right time.
Direct CPA access: You can email us, call us, or ask questions anytime. No waiting for “CPA office hours” or paying extra for tax advice. We’re your accounting team, not a software subscription with limited support tickets.
Compare that to what you get with accounting software like Heard: automated transaction categorization, financial dashboards, and limited access to CPAs for specific questions. The software might be cheaper, but it’s not doing the strategic work that actually saves you money.
Why Therapy-Specific Expertise Actually Matters
Here’s the thing about therapy practice finances: they’re weird.
Your income doesn’t show up when you earn it. Insurance companies pay weeks or months later. You might see 25 clients in a week and only get paid for half of them that month. Meanwhile, your rent, your EHR subscription, your liability insurance – all of that hits on schedule.
A generic CPA or accounting software doesn’t get this. They see your bank account balance and assume that’s your income. They don’t understand why you’re cash-poor in February but flush in March.
We do. Because we only work with therapists and private practice owners.
Here’s what commonly gets missed when you work with a generalist, use software, or try to DIY your accounting:
- Professional membership fees to organizations like the American Counseling Association
- Therapeutic aids used in session include weighted blankets, sand trays, art therapy supplies, games, and fidget toys
- Continuing education costs covering tuition, online courses, workshops, conference attendance, and supervision
- The timing of insurance reimbursements and how that affects your quarterly tax calculations
- When S-corp election actually makes sense versus when it’s just extra paperwork that costs you money
- How to structure group practice payroll to avoid cash flow disasters
Failing to claim these expenses can cost you hundreds or thousands in missed deductions. But it’s not just about missing write-offs. It’s about not understanding the structure of your business well enough to make good decisions.
We’ve seen therapists who were booked solid (25+ clients a week) and barely breaking even. Their overhead was eating them alive, and nobody had told them. A CPA who understands therapy practices spots that problem immediately.
What Changed in 2026 That Actually Matters
Starting in 2026, taxpayers who take the standard deduction can also deduct up to $1,000 of qualified cash charitable contributions each year. This deduction is available in addition to the standard deduction.
If you regularly make modest donations to qualified charities, those gifts may now reduce your taxable income.
The QBI deduction is now permanent. This allows up to a 20% deduction on qualified business income from pass-through entities like sole proprietorships and S-corps. There’s also a new minimum QBI deduction for taxpayers who have at least $1,000 in qualified business income.
You can read more about how these changes affect you in our guide to tax deductions for therapists in 2026.
But here’s the part that matters: knowing these rules exist doesn’t help you unless someone is applying them to your specific situation every quarter.
Software vs. CPAs: What’s The Actual Difference?
Let’s be really clear about what you’re getting when you pay for accounting software versus when you hire a CPA firm.
Accounting software (like Heard):
- Connects to your bank accounts and credit cards
- Automatically categorizes transactions (often incorrectly)
- Generates financial reports and dashboards
- Offers limited CPA support for specific questions (usually as an add-on)
- Handles basic tax filing (sometimes included, sometimes extra)
The software might cost less per month, but it’s doing the bare minimum. You’re still responsible for understanding your numbers, planning your taxes, and making strategic decisions.
A real CPA firm (like us):
- Does everything the software does, but accurately
- Provides year-round proactive tax planning
- Calculates quarterly estimated payments based on your specific cash flow
- Advises on business structure decisions (S-corp vs. Schedule C, when to hire, how to pay yourself)
- Understands therapy practice finances specifically
- Catches expensive mistakes before they happen
- Finds deductions you didn’t know existed
- Gives you direct access to CPAs who know your business
The difference? Software gives you data. CPAs give you a strategy.
For example: S-corp election. This is a huge decision that can save you thousands in self-employment taxes if done at the right time. The income threshold at which it starts making sense is generally around $100,000 in profit. Below that, the QBI deduction often makes staying a Schedule C filer better.
Software won’t tell you when to make that election. A CPA firm will.
If you want to run the numbers yourself, you can use our free S-Corp vs PLLC calculator.
Here’s The Bottom Line On Price
We charge $250-$450/month. That’s probably cheaper than you expected for a full-service CPA firm that specializes in therapy practices.
Compare that to Heard, which starts at around $250/month for their software plus add-ons for CPA support. Except with Heard, you’re getting software with limited CPA access. With us, you’re getting actual CPAs managing your entire financial picture.
Or compare it to hiring a generic CPA: $200-500/hour for someone who doesn’t understand therapy practices, doesn’t do monthly bookkeeping, and bills you every time you ask a question.
How to Know If We’re Right For You
We’re a good fit if you want monthly bookkeeping, proactive tax planning, and someone who actually understands the financial side of running a therapy practice.
We’re not a good fit if you just want someone to file your taxes once a year and leave you alone the rest of the time.
If you want to talk through your specific situation and see if we can help, you can schedule a call with us here.
We’ll look at what you’re currently doing, where the gaps are, and whether working together makes sense.
TL;DR:
No pressure. No sales pitch. Just a real conversation about your practice finances.TL;DR: We charge $250-$450/month for full-service CPA accounting built specifically for therapists. That’s competitive with software-only solutions like Heard, except we’re actual CPAs doing proactive year-round tax strategy, not just software with limited CPA access. We catch expensive mistakes before they happen, find therapy-specific deductions that generic CPAs miss, and understand insurance reimbursement timing. The most affordable option isn’t the cheapest price tag. It’s the one that saves you more than you pay.
