How To Find The Right CPA For Your Therapy Practice

Running a private practice—especially in mental health or other healthcare settings—comes with unique financial challenges. This is where a good CPA can make all the difference.

By partnering with a skilled and experienced professional, you can offload tasks you dislike (or aren’t good at) such as bookkeeping, estimated taxes, and tax planning.

If your CPA stinks, these tasks won’t get done properly and you will experience even more stress than if you had just done it yourself.

This article will help you consider the things you should look for when hiring a CPA for your private practice.

Choose a CPA with Experience in Your Field

Look for a CPA who has direct experience working with healthcare or mental health professionals. This ensures they understand the intricacies of running a private practice. A CPA familiar with private practice nuances will also be better equipped to identify potential tax deductions and strategies specific to your profession as well as your personal situation.

Things to consider:

Reputation & References

• Ask for References: This is something that almost no one does but is the single best way to find out if the CPA you’re thinking of hiring is right for you. Request references from current or former clients in the same industry as you. Hearing about others’ experiences will give you insight into the CPA’s style, expertise, and reliability.
• Check Online Reviews: Just like we all read reviews before purchasing a $15 pepper grinder on Amazon, it’s crucial to evaluate any professional who will handle your financials. Do a quick scan of Google reviews just like you would for anything else.

Range of Services Provided

We can put CPA service offerings into three styles:

• “Do it yourself” – inexpensive but very time-consuming for you.
• “Done with you” – middle of the road. This is the option that inevitably leads to finger-pointing and I would advise against it.
• “Done for you” – the least time-consuming, most accurate, but most expensive option.

Before making a decision, clarify which of the three models a prospective CPA uses and compare that approach to the level of support you’re seeking (and willing to pay for).

I wrote a short article that further describes these three CPA-therapist relationships that I think you will find very helpful.

Other considerations:

Scalability! Your CPA should have the bandwidth and expertise to support you at your various stages of growth. That is, not just the practice you currently have, but also with the practice you aim to create in the long run.

Confirm that they can handle the potential increase in financial complexity. And ask if they have clients in your current category as well as the level you’re looking to achieve.

Communication and Advisory Skills

Some CPAs will do a great job with your books and with your tax returns, but might be shy about giving business advice. And they might be terrible at explaining things and answering your seemingly simple questions (most CPAs aren’t known for their communication skills).

Other CPAs don’t mind hopping on a call with their clients to discuss “high view” items like:

• “How can I grow my practice?”
• “What are your thoughts on picking a niche vs general practice?”
• Or maybe just a sanity check for the common question, “Am I even doing this right???”

If you think you would benefit from conversations like these, try to gauge the CPAs willingness–or lack thereof–in having these check-ins.

Responsiveness

Speaking of communication, ask explicitly what their typical response time is. Slow response times–or ignoring requests altogether–is hands down the most common reason why practice owners switch CPAs.

In addition to timeliness, clarify up front if the CPA prefers email, phone, or video calls, and how often you can expect touchpoints.

Also, some CPA firms only ramp up availability during tax season. However, ongoing, year-round support is essential to effective tax planning and financial oversight. Make sure the CPA you hire is available all year, not just during tax time.

Technological Proficiency and Data Security

Modern Accounting Software – Inquire about which software tools or cloud-based platforms the CPA uses (e.g., QuickBooks, Excel, Xero) to manage and track your financials. A good CPA will use software that their clients can access independently whenever they have the urge.

HIPAA Considerations – Confirm that your CPA understands HIPAA rules as they apply to financial data. While we typically don’t need access to patient health information directly, some reports you share might have confidential info included. Make sure your prospective CPA is comfortable with HIPAA rules and regulations.

Data Security – How does the CPA send sensitive documents back and forth to their clients (you)? Email attachments are a data breach waiting to happen. If the CPA you want to hire doesn’t have a secure portal, keep looking.

CPA Fees and Value Assessment

Fee Arrangements

CPAs may bill hourly, monthly, or project-based. They may be fixed or variable.

I personally think flat-fee billing is the best option. No surprises, no unanticipated charges. Some practice owners may prefer hourly billing (think of the way attorneys usually charge), but most prefer the simplicity and predictability of flat fees.

Return on Investment

An effective CPA might cost more than a bare-bones accountant, but they can save you significant money in the long run—through better tax strategies, reduced risk of penalties, and more efficient operations.

What’s harder to calculate–but probably more important to consider–is the time, stress, and mental bandwidth that a good CPA will save you from.

Personal Compatibility: Finding a CPA You Actually Like

Despite the popular opinion that CPAs are robots, they are in fact human beings (at least in most cases). You’ll be regularly collaborating with this person, so compatibility matters a ton.

Choose someone whose communication style resonates with you. Ask yourself the simple question, “do I like talking with this person?” If their offer sounds great, but you don’t like them on a personal level, you’re going to end up unhappy.

Red Flags to Avoid

• Lack of Specialty or References in Healthcare. A general CPA might miss key deductions or compliance requirements pertinent to therapy practices. Look for someone with a proven track record in your field.
• Hidden Fees or Unclear Billing. If the fee structure seems opaque or you discover unexpected charges, consider it a warning sign that the partnership may not be transparent or beneficial.
• Negative Reviews or lack of references (obviously)

Conclusion

Hiring the right CPA can transform your private practice finances from a source of stress to a strategic advantage. Remember to consider relevant industry experience, the scope of services offered, communication style, billing methods, and personal fit before making your decision.

Take the time to interview multiple candidates, verify their credentials, and ensure their approach aligns with your vision. By bringing on a CPA whose style jives with yours, you’ll be able to reduce financial burdens, avoid costly mistakes, and stay focused on things you like, things you’re good at, and/or things that make you money.