How to start an occupational therapy private practice

Start an OT private practice by defining a service you are qualified and equipped to deliver, verifying the business and professional requirements where you practice, building a financial plan from real quotes, and testing the whole inquiry-to-care workflow before promoting appointments. Decide separately whether you serve children, adults, or both.

A profession-wide description of OT is not a service plan for an individual clinic. This guide follows the order the work tends to happen in: the offering, the license, the business, identifiers and payers, the setting, the money, the systems, a test run and the opening checklist.

What are the steps to start an occupational therapy private practice?

The work falls into eight steps, and each one has a test it should pass before the next begins. The order matters: a lease signed before the service is defined, or a website published before the intake route works, creates commitments the rest of the plan has to work around.

1. Define the offering. Write the service statement and the limits, separately for pediatric and adult services.
2. Confirm the license. Hold an active license in each state where you provide OT, or a compact privilege that state has issued.⁠^1,5
3. Set up the business. Choose the structure, register it, get an EIN, open a business bank account and buy the insurance the plan needs.
4. Get identifiers and decide on payers. Get an NPI, decide whether to enroll in Medicare and which plans to apply to, and start applications early.
5. Choose the setting. Test an office, home visits or telehealth against the service, the population and the payer rules.
6. Budget the launch. Separate one-time costs, monthly costs and reserves, and model cash on slow collections.
7. Build the systems. Assign who reviews fit, collects information, explains payment, schedules and keeps records.
8. Test, then open. Run realistic inquiries end to end, fix the first broken step, then publish accurate pages and profiles.

The rest of this guide takes each step in turn. The startup budget worksheet and the credentialing guide go deeper on steps 4 and 6.

What OT services should a new private practice offer?

Offer the specific services your clinicians are competent and equipped to deliver now, described by population, activity, setting and limits. Write a service statement naming the population, activities addressed, setting, clinician, and important limits. Pediatric services may focus on particular everyday activities and participation within your competence. Adult services may address daily tasks, work, or other participation needs.

AOTA defines occupations as the activities that people do every day to give their life meaning and purpose, and the practice framework groups them as activities of daily living, instrumental activities of daily living, health management, rest and sleep, education, work, play, leisure and social participation.⁠⁶ That breadth describes the profession, not one clinic, and families often meet it through general pages such as DrSensory’s guide to occupational therapy. Do not advertise feeding, hand therapy, neurological rehabilitation, or any other offering merely because it appears in a general OT description.

Document what an evaluation requires: space, equipment, records, scheduling time, and any relevant coordination. Decide what requests need another provider or setting. A narrow accurate launch is easier to operate than a profile promising every OT service.

How do you write a service statement for an OT practice?

Name five things in one or two sentences: who the service is for, what everyday activities it addresses, where it happens, who provides it and what it does not include. Then have the treating clinician confirm it before anyone publishes it.

Use the same statement on the website, in directory profiles and in the referral sheet, so a caregiver, an adult client and a referring clinician all read the same boundaries. The pediatric service page guide and the adult service page guide show how to turn it into a full page.

Which requests should a new OT practice redirect elsewhere?

Redirect any request that needs competence, equipment, a setting or a schedule the practice does not have yet. Write the redirect list before opening, with the reason and a suggested next step for each, so the person answering the phone does not improvise. A request outside the service is not a failure of marketing; it is information about where the public description may be too broad.

Do you need a license to open an occupational therapy practice?

Yes. All 50 states, the District of Columbia, Puerto Rico and Guam require occupational therapists and occupational therapy assistants to be licensed to provide OT, and a license grants the privilege to practice in the state that issued it.⁠¹ The license is not the same as the certification earned by passing the NBCOT exam, so a current certification does not replace an active state license.⁠¹

Read your state’s practice act and rules before you write the service statement, not after. AOTA’s state resources compare referral requirements, OTA supervision requirements, scope of practice and telehealth laws by state, which are exactly the rules that change what a private practice can offer and how.⁠¹ A rule that differs by state belongs in the requirements register with its source and the date it was read.

Can an OT practice see clients in other states through the OT Compact?

Only once the state has opened applications and your privilege is approved. The OT Compact says you cannot practice in a compact state under the compact, even if that state has enacted the legislation, until it opens applications, deems you eligible and approves your application; until then you need a license in each state where you provide OT.⁠⁵

In October 2026, the compact’s state table listed 36 member states, ten of them accepting applications: Arkansas, Indiana, Maryland, Minnesota, Mississippi, Ohio, Tennessee, Virginia, West Virginia and Wisconsin.⁠⁷ Each privilege carries the $75 compact fee plus a state fee that varies, and your home state must be a member state where you live and hold your license.⁠⁷

For telehealth across state lines, HHS’s telehealth site lists the routes as a full license, temporary practice laws, reciprocity, a compact or a telehealth registration where one exists, and advises providers to verify the patient’s location before each appointment.⁠⁸ Do not announce broad geographic availability until each route is confirmed for the states you name.

How do you set up the business side of an OT private practice?

Choose a business structure, register it with the state, get the federal tax ID, open a separate bank account and buy insurance, in roughly that order. The SBA notes that the structure affects how much you pay in taxes, your ability to raise money, the paperwork you file and your personal liability, and that registering usually costs less than $300, with fees varying by state and structure.⁠⁹

Apply for the EIN directly with the IRS, which issues it online for free; if you are forming an LLC or a corporation, form it with the secretary of state first.⁠¹⁰ Open a business bank account once you start accepting or spending money as the business.⁠⁹ If you plan an office, check local zoning before signing anything, because zoning can apply even to a home-based business.⁠⁹

Insurance is part of the setup, not an afterthought. The SBA lists professional liability insurance for businesses that provide services, covering losses from malpractice, errors and negligence, and says businesses with employees need workers’ compensation, unemployment and disability insurance, with requirements that vary by state.⁠⁹

What goes in an OT practice requirements register?

Create a requirements register with the authority, actual rule, responsible person, evidence, and renewal date. Review professional licensure, permitted business structure, local premises requirements, professional and business insurance, information handling, and payment arrangements with the appropriate owners. Do not assume a business registration authorizes clinical practice.

The register is the document the opening review checks against, so record where each rule came from and when it was read.

Do state laws limit which business entity an OT practice can use?

Yes, and the differences are real. In California, the Corporations Code does not permit a limited liability company to render professional services, which it defines as services that may be lawfully rendered only under a license authorized by the Business and Professions Code.⁠^11,12 The same code provides for an occupational therapy corporation, a physical therapy corporation and a speech-language pathology corporation, with limits on which other licensees may hold shares.⁠¹³ Other states treat professional entities differently, so confirm the permitted structure with your state and an attorney before filing.

Do you need an NPI and Medicare enrollment to open an OT practice?

You need an NPI to bill health plans, and Medicare enrollment if you plan to treat Medicare patients. An individual gets one Type 1 NPI; an incorporated practitioner can also get a Type 2 NPI for the corporation or LLC.⁠² An NPI is an identifier, not proof of licensure or payer acceptance: CMS states that having one does not ensure a provider is licensed or credentialed, does not mean a health plan pays and does not enroll the provider in a health plan.⁠² Changes to the NPI record are reported within 30 days.⁠²

Medicare enrollment has four steps: get an NPI, complete the application in PECOS, pay the application fee if one applies, and work with your Medicare Administrative Contractor.⁠¹⁴ Occupational therapists are on CMS’s list of providers who cannot opt out of Medicare, and CMS notes that a practitioner who does not see Medicare patients does not have to enroll or opt out.⁠¹⁵ The credentialing guide covers commercial plans, Medicaid and the status labels to track.

What does Medicare require of an OT in private practice?

To bill Medicare directly, each OT in private practice must be legally authorized by the state, practice on a regular basis in a solo practice, partnership or group practice, or as an employee of one, and bill only for services furnished in the practice’s office space or the patient’s home.⁠³ Office space must be owned, leased or rented by the practice and used for the exclusive purpose of operating it.⁠³ An OTA may work under the private practice OT’s general supervision, while an OT who is not enrolled must work under direct supervision.⁠³

Outpatient OT is covered when a physician or NPP certifies the plan of care; the initial certification is due within 30 calendar days of the first treatment day, including the evaluation, and recertification at least every 90 calendar days.⁠⁴ For 2026, once a patient’s OT services for the year pass $2,480, claims must carry the KX modifier, which confirms that the services are medically necessary as documented in the record, and claims over the threshold without it are denied.⁠¹⁶ Services furnished in whole or in part by an OTA are paid at 85 percent of the amount otherwise paid, which belongs in the revenue model if the practice plans to hire assistants.⁠^3,16

How do you choose a location for an OT private practice?

Choose the setting the service needs, then check it against the population, the law and the payers. Evaluate an office against the real offering rather than appearance alone. Consider activity space, equipment storage, privacy, arrival access, cleaning, emergency procedures, and the ability to accommodate the intended population. Do not sign a lease based on an assumed service model that has not been reviewed.

For pediatric care, assess caregiver participation, waiting arrangements, and usable appointment windows. For adults, assess mobility access, transport-related arrival, communication options, and the actual activities involved. A kitchen, bathroom or community-skills area serves different adult goals than a pediatric gross motor space, so the floor plan follows the service statement.

Accessibility is a legal requirement as well as a practical one. ADA.gov states that private medical offices are covered by Title III of the ADA as places of public accommodation, that existing facilities must remove architectural barriers where removal is readily achievable, and that Section 504 can also apply to providers paid by Medicare or Medicaid.⁠¹⁷ Do not label the setting accessible without checking the entrance, restroom, treatment surfaces and parking yourself.

If the practice plans to bill Medicare, the space has to be used for the exclusive purpose of operating the practice, which rules out some sublet and shared arrangements.⁠³ Zoning applies to offices and can apply to home-based businesses.⁠⁹

Can an OT practice start with home visits or telehealth?

Yes, when the service, the client and the rules support it. Home-based or telehealth services need their own scope and operational review; they are not automatic substitutes for an office offering. Medicare lets an OT in private practice bill for services in the patient’s home, and CMS reports that Congress extended OTs’ ability to furnish Medicare telehealth services through December 31, 2027.⁠^3,16

For each mode, write down travel time, equipment that has to move, the privacy of the space, how a caregiver or support person takes part and what happens when a session cannot go ahead. Families comparing options often read pages like in-home therapy and teletherapy for children, so describe your own arrangements in the same plain terms.

How much does it cost to start an OT private practice?

There is no reliable single figure, because the cost depends on the service, the setting, the equipment and the location. Separate startup purchases, deposits, monthly fixed expenses, variable service costs, owner compensation, and a cash reserve. Obtain actual quotes. Do not use an unsourced “typical OT startup cost” as your financing plan.

The SBA suggests sorting expenses into one-time and monthly costs and counting at least one year of monthly expenses, ideally five.⁠¹⁸ Equipment lists differ widely: a pediatric clinic built around play and sensory-motor activity and an adult practice built around daily living tasks do not share a shopping list, and neither should borrow the other’s budget.

Calculate expected collections using conservative scenarios rather than full calendar capacity. Payment delays, cancellations, administrative work, and gradual referral development affect cash timing. Medicare, for example, cannot pay a clean electronic claim before the 14th day after it arrives, and must pay or deny it within 30 days.⁠¹⁹

Taxes belong in the monthly plan. A sole proprietor or LLC member generally pays self-employment tax of 15.3 percent on net earnings of $400 or more, and generally makes estimated tax payments across four periods of the year when expecting to owe $1,000 or more.⁠^9,20,21 The IRS also lets a new business elect to deduct up to $5,000 of start-up costs, reduced when start-up costs exceed $50,000.⁠²²

The startup budget worksheet lays out the line items, the three collection scenarios and the runway calculation.

Which systems does a new OT practice need for intake and records?

A new practice needs an owned route for every step from first contact to the record of care, and the systems come after the route is mapped. Define who reviews clinical fit, collects necessary information, explains payment, schedules evaluations, maintains records, and handles follow-up. Select systems after mapping the information flow and applicable obligations. A vendor’s marketing label does not establish that your actual use is appropriate.

Prepare consent, communication, record, billing, and scheduling procedures through qualified review. Build separate caregiver and adult-support-person workflows. For adult patients, address the patient directly and establish preferences and any applicable representative authority: under HIPAA, an adult’s personal representative is a person with legal authority to make health care decisions for them, such as a health care power of attorney.⁠²³ ADA.gov gives the same instruction for appointments, to address the patient rather than the companion.⁠¹⁷

The intake call script, the new patient email templates and the accessible inquiry form guide give the wording for the first steps, and the payment explanation guide covers participation, benefits and authorization in plain language.

Does HIPAA apply to a small OT private practice?

HHS treats a health care provider as a covered entity, bound by the HIPAA Rules, only if it transmits information electronically in connection with a transaction for which HHS has adopted a standard.⁠²⁴ A covered entity that uses a vendor to handle protected health information on its behalf needs a written business associate agreement, and HHS lists record-system vendors and cloud services that store health information among business associates.⁠^24,25 Ask every vendor for its agreement before any client information goes into the system.

How do you test an OT practice launch before promoting appointments?

Run realistic inquiries through every step, with administrative test information, and fix what breaks before any campaign. Use administrative test information for a caregiver requesting the actual pediatric service, an adult requesting the actual adult service, and a professional sending a referral. Check the website, contact route, service-fit review, payment explanation, appointment offer, and record handoff.

1. A caregiver inquiry. A parent asks about the pediatric service by phone after school hours. Who hears the message, and when does the parent hear back?
2. An adult inquiry. An adult asks by email about the adult service and mentions a preferred way to communicate. Does the reply go to the adult and use that route?
3. A professional referral. A referring clinician sends records for a request near the edge of the service. Who decides fit, and what does the referrer hear?
4. An out-of-scope request. Someone asks for a service the practice does not provide. Does the response explain the limit and suggest a next step?
5. A payment question. A caller asks whether their plan is accepted. Does the answer match what the practice can actually confirm today?

A working launch process should explain what happens next without promising a treatment schedule before evaluation.

How do you know each stage of an OT practice launch is complete?

Each stage is complete when it passes a test someone other than its author can check. Use the table as the opening checklist, and do not count the website going live as the finish line.

Complete the service statement and requirements register. Then build the startup budget and assign the launch workflow before promoting appointments. Use the OT growth guides, for adult OT clients and pediatric OT clients, once the service is operational. Marketing should describe deliverable care access, not compensate for unfinished preparation. Directory profiles, including a DrSensory profile, should go live only when every detail on them is true, and the 90-day marketing plan sets out the first promotion once they are.

Sources

1. American Occupational Therapy Association. State Occupational Therapy Licensure (Career: Licensure). “All 50 states in the United States plus the District of Columbia, Puerto Rico, and Guam require occupational therapists and occupational therapy assistants to be licensed to provide occupational therapy services”; “A license grants you the legal privilege to practice occupational therapy in the state in which you are licensed”; “Your occupational therapy license is not the same as the certification that you earn by passing the exam administered by the National Board for Certification in Occupational Therapy (NBCOT).” Its state-by-state resources include referral requirements, OTA supervision requirements, scope of practice by state, and telehealth laws, regulations and guidance. Checked October 8, 2026.
2. Centers for Medicare & Medicaid Services. NPI Fact Sheet (December 2024). Type 1 NPIs are “For individual health care providers, such as physicians, nurse practitioners and sole proprietors. Individuals are only eligible for one NPI”; Type 2 are “For health care organizations”; “An individual who is a health care provider and is incorporated, can obtain an NPI for themselves (Type 1) and an NPI for their corporation or LLC (Type 2)”; “Having an NPI does not: Ensure a provider is licensed or credentialed; Guarantee payment by a health plan; Enroll a provider in a health plan”; “you must report any changes to the information provided for your NPI within 30 days of the change”; “A provider or supplier will not receive payment from Medicare until it is properly certified and enrolled in the Medicare program.” Checked October 8, 2026.
3. Code of Federal Regulations. 42 CFR 410.59, Outpatient occupational therapy services: Conditions. eCFR text, current as of October 6, 2026. An OT in private practice must “Engage in the private practice of occupational therapy on a regular basis as an individual, in one of the following practice types: a solo practice, partnership, or group practice; or as an employee of one of these” and “Bill Medicare only for services furnished in his or her private practice office space, or in the patient’s home”; “When services are furnished in private practice office space, that space must be owned, leased, or rented by the practice and used for the exclusive purpose of operating the practice”; “Occupational therapy services may be performed by an occupational therapy assistant under the general supervision of the occupational therapist in private practice; services performed by an unenrolled occupational therapist must be under the direct supervision of the occupational therapist”; claims for services furnished in whole or in part by an OTA “are paid an amount equal to 85 percent of the amount of payment otherwise applicable for the service.” Checked October 8, 2026.
4. Centers for Medicare & Medicaid Services. Complying with Outpatient Rehabilitation Therapy Documentation Requirements (MLN Fact Sheet MLN905365, September 2025). Outpatient PT, OT and SLP services are covered when the “Physician or NPP certifies the treatment plan, also called the plan of care (POC)”; “The physician or NPP certifies the initial POC with a dated signature or verbal order within 30 calendar days from the first day of treatment, including evaluation”; recertification comes “at least every 90 calendar days after treatment starts”; from January 1, 2025, a physician’s or NPP’s dated signature on the order or referral may substitute for a signature on the initial POC that has not been returned within 30 calendar days of the initial evaluation. Checked October 8, 2026.
5. Occupational Therapy Licensure Compact Commission. Status of the OT Compact (updated October 2026). “You cannot practice in an OTC state under the OT Compact, even if that state has enacted OTC legislation. You can only apply when the state opens applications, deems you eligible to apply, AND your application is approved”; “Until you receive your OTC privilege to practice, you need a license to practice in any state you wish to provide OT services”; a compact privilege is described as “equivalent to a license.” Checked October 8, 2026.
6. American Occupational Therapy Association. Occupations and everyday activities (Practice: Domain and Process). “Occupations are the activities that people do every day to give their life meaning and purpose”; “The broad range of occupations is categorized in the Occupational Therapy Practice Framework (OTPF-4) as activities of daily living, instrumental activities of daily living, health management, rest and sleep, education, work, play, leisure, and social participation.” Checked October 8, 2026.
7. Occupational Therapy Licensure Compact Commission. Before You Apply for an OT Compact Privilege. The state table lists 36 member states; ten were accepting OT Compact applications: Arkansas and Mississippi (October 5, 2026), Indiana (March 9, 2026), Maryland (April 15, 2026), Minnesota, Ohio and West Virginia (January 12, 2026), Tennessee (May 20, 2026), Virginia (March 20, 2026) and Wisconsin (May 29, 2026); the rest read “Not Yet.” The OT Compact fee is $75 for OTs and OTAs in every state, plus a state fee that varies by state. Home state means a member state “where you live (primarily reside) AND hold a license to practice as an OT/OTA in that state.” Checked October 8, 2026.
8. U.S. Department of Health and Human Services. Licensing across state lines (Telehealth.HHS.gov; last updated April 30, 2025). “The ability to deliver health care services across state lines varies based on state regulations”; the routes it lists are “Obtaining a full license; Checking temporary practice laws; Seeing if there is licensure reciprocity; Joining a licensure compact; and/or Applying for telehealth registration if available”; “Prior to an appointment, providers should verify patient location and obtain consent.” Checked October 8, 2026.
9. U.S. Small Business Administration. Launch your business. “Your business structure affects how much you pay in taxes, your ability to raise money, the paperwork you need to file, and your personal liability”; “members of an LLC are considered self-employed and must pay self-employment tax contributions towards Medicare and Social Security”; “In most cases, the total cost to register your business will be less than $300, but fees vary depending on your state and business structure”; “It’s free to apply for an EIN”; a physical location should conform “to local zoning requirements,” and “zoning ordinances can still apply even to home-based businesses”; “The licenses and permits you need from the state, county, or city will depend on your business activities and business location”; “Some licenses and permits expire after a set period of time”; “The federal government requires every business with employees to have the following”: workers’ compensation, unemployment and disability insurance, and “Laws requiring insurance vary by state”; professional liability insurance “protects against financial loss as a result of malpractice, errors, and negligence”; “As soon as you start accepting or spending money as your business, you should open a business bank account”; “Business banking offers limited personal liability protection by keeping your business funds separate from your personal funds.” Checked October 8, 2026.
10. Internal Revenue Service. Get an employer identification number (page last reviewed or updated August 19, 2026). “Use this tool to get an EIN directly from the IRS in minutes for free”; “You never have to pay a fee for an EIN”; “If you are creating a corporation or LLC, form your entity through the secretary of state before you apply for an EIN.” Checked October 8, 2026.
11. California Legislative Information. California Corporations Code §17701.04. Subdivision (e): “Nothing in this title shall be construed to permit a domestic or foreign limited liability company to render professional services, as defined in subdivision (a) of Section 13401 and in Section 13401.3, in this state.” Checked October 8, 2026.
12. California Legislative Information. California Corporations Code §13401. “‘Professional services’ means any type of professional services that may be lawfully rendered only pursuant to a license, certification, or registration authorized by the Business and Professions Code, the Chiropractic Act, or the Osteopathic Act.” Checked October 8, 2026.
13. California Legislative Information. California Corporations Code §13401.5. Designates, among others, a “Speech-language pathology corporation,” a “Physical therapy corporation” and an “Occupational therapy corporation,” and lists the other licensed persons who may hold shares in each, “so long as the sum of all shares owned by those licensed persons does not exceed 49 percent of the total number of shares.” Checked October 8, 2026.
14. Centers for Medicare & Medicaid Services. Become a Medicare Provider or Supplier (page last modified June 2, 2026). The four steps: “Get an NPI”; “Complete the Medicare Enrollment Application” in PECOS; “Pay the Medicare Application Fee, if applicable”; “Work With Your MAC.” A change in ownership, an adverse legal action or a change in practice location is reported within 30 days; “You must report all other changes within 90 days.” Checked October 8, 2026.
15. Centers for Medicare & Medicaid Services. Manage Your Enrollment (page last modified March 4, 2026). “Physicians and practitioners who see Medicare patients but don’t want to enroll in the Medicare program must opt-out of Medicare”; “If you don’t see Medicare patients, you don’t have to enroll in or opt-out of Medicare”; the list of “Providers NOT Eligible to Opt Out” includes “Occupational therapists,” “Physical therapists” and “Qualified speech language pathologists.” Checked October 8, 2026.
16. Centers for Medicare & Medicaid Services. Therapy Services (page last modified March 10, 2026). The law keeps the former therapy cap amounts “as thresholds above which claims must include the KX modifier as a confirmation that services are medically necessary as justified by appropriate documentation in the medical record,” with “one amount for PT and SLP services combined and a separate amount for OT services”; “For CY 2026 this KX modifier threshold amount is: $2,480 for PT and SLP services combined, and $2,480 for OT services”; “Claims for services over the KX modifier threshold amounts without the KX modifier are denied”; section 6209 of the Consolidated Appropriations Act, 2026 “extended the ability of PTs, OTs, and SLPs to furnish Telehealth Services … through December 31, 2027”; for PT and OT services furnished in whole or in part by PTAs and OTAs, “Payment for these services is at 85 percent of the otherwise applicable PFS payment amount/rate for the service, effective January 1, 2022.” Checked October 8, 2026.
17. U.S. Department of Justice, Civil Rights Division. Access to Medical Care for Individuals with Mobility Disabilities (ADA.gov; last updated June 26, 2020). “Private hospitals or medical offices are covered by Title III of the ADA as places of public accommodation”; Section 504 covers those that receive federal financial assistance, “which can include Medicare and Medicaid reimbursements”; “Under Title III, existing facilities are required to remove architectural barriers where such removal is readily achievable”; asked whether a provider can turn away a patient for lack of accessible medical equipment, it answers “Generally no”; a good option is “a table that adjusts down to the level of a wheelchair, approximately 17-19 inches from the floor”; “You should always address the patient directly, not the companion”; “The receptionist should ask each individual who calls to make an appointment if the individual will need any assistance at the examination because of a disability.” Checked October 8, 2026.
18. U.S. Small Business Administration. Plan your business. Its list of common startup costs: office space, equipment and supplies, communications, utilities, licenses and permits, insurance, lawyer and accountant, inventory, employee salaries, advertising and marketing, market research, printed marketing materials and making a website; “organize your expenses into one-time expenses and monthly expenses”; “You’ll want to count at least one year of monthly expenses, but counting five years is ideal”; “Fixed Costs ÷ (Price – Variable Costs) = Break-Even Point in Units.” Checked October 8, 2026.
19. Centers for Medicare & Medicaid Services. Medicare Claims Processing Manual, Chapter 1, General Billing Requirements (Rev. 13725, issued April 10, 2026), §§80.2.1.1–80.2.1.2. “‘Clean’ claims must be paid or denied within the applicable number of days from their receipt date,” 30 days for claims received from October 1, 1993; the payment floor “establishes a waiting period during which time the contractor may not pay, issue, mail, or otherwise finalize the initial determination on a clean claim,” with the earliest payment on the “14th day for HIPAA-compliant EMC” and the “29th day for paper.” Checked October 8, 2026.
20. Internal Revenue Service. Self-employment tax (Social Security and Medicare taxes) (page last reviewed or updated June 27, 2026). “The self-employment tax rate is 15.3%. The rate consists of two parts: 12.4% for social security (old-age, survivors, and disability insurance) and 2.9% for Medicare (hospital insurance)”; it is owed when “Your net earnings from self-employment (excluding church employee income) were $400 or more.” Checked October 8, 2026.
21. Internal Revenue Service. Estimated taxes (page last reviewed or updated September 25, 2026). “Individuals, including sole proprietors, partners, and S corporation shareholders, generally have to make estimated tax payments if they expect to owe tax of $1,000 or more when their return is filed”; “For estimated tax purposes, the year is divided into four payment periods.” Checked October 8, 2026.
22. Internal Revenue Service. Publication 583, Starting a Business and Keeping Records (December 2024). “Business start-up costs are the expenses you incur before you actually begin business operations”; “You can elect to deduct up to $5,000 of business start-up costs and up to $5,000 of organizational costs. The $5,000 deduction for start-up costs and the $5,000 deduction for organizational costs is reduced by the amount your start-up or organizational costs exceed $50,000. Any remaining costs must be amortized”; “Everyone in business must keep records.” Checked October 8, 2026.
23. U.S. Department of Health and Human Services, Office for Civil Rights. Personal Representatives (HIPAA Privacy Rule guidance, 45 CFR 164.502(g); content last reviewed January 5, 2024). For an adult, the personal representative is “A person with legal authority to make health care decisions on behalf of the individual,” such as a health care power of attorney or a court-appointed legal guardian; “In most cases under the Rule, a parent, guardian, or other person acting in loco parentis (collectively, ‘parent’) is the personal representative of the minor child”; the exceptions “generally track the ability of certain minors to obtain specified health care without parental consent under State or other laws.” Checked October 8, 2026.
24. U.S. Department of Health and Human Services, Office for Civil Rights. Covered Entities and Business Associates (content last reviewed August 21, 2024). Health care providers are covered entities “but only if they transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard”; “If a covered entity engages a business associate to help it carry out its health care activities and functions, the covered entity must have a written business associate contract or other arrangement with the business associate.” Checked October 8, 2026.
25. U.S. Department of Health and Human Services, Office for Civil Rights. Business Associates (content last reviewed July 30, 2026). Examples of business associates include a “Cloud service provider engaged to create, receive, maintain, or transmit electronic PHI (ePHI)” and an “IT contractor or vendor (e.g., EHR vendor, Managed Services Provider) that provides maintenance and/or support services” for systems holding ePHI; “A business associate is also directly liable for complying with certain provisions of the HIPAA Rules.” Checked October 8, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It is general guidance on starting and running a therapy practice, not legal, tax, compliance, billing or financial advice. Its numerical examples are hypothetical, not DrSensory data or industry benchmarks.