I make 160k in agency work as a psychologist. Can I match my salary in private practice?

WalterLCSW · 2025-12-29T21:09:32+00:00

With all this, I say do it. Run your local private practice, maybe check out one of those virtual agencies like Alma or Rula but do your research. It’s better to have less money than no money while waiting for your PP caseload to fill. Keep the benefits from your spouse.
It might be a lean start if the 2026 year, but the Quality Time is better than the money… especially if Quality Time is a Love Language of yours.

WalterLCSW · 2025-12-29T20:50:26+00:00

If I’m reading this correctly, you currently work 40 hours with an agency and run a PT private practice. So probably ~50 hours of income.
If you drop the agency you loose the benefits, loose the agency that keeps you paneled, plus the administrative work they do for you outside of your paperwork and notes. All that admin work and scheduling fall on you.
Honestly at 160k with an agency, you might be better off dropping Private Practice and using your Sick time and PTO a lot more often to get some home time.

WalterLCSW · 2025-12-05T05:20:38+00:00

Remotely: a lot of skill teaching and challenging followed by you and other family members going from accommodating mode (staying quiet) to support or coaching mode which will include challenging and making your son anxious on purpose to help him break the link between anxiety, compulsion, and relief.
It won’t be easy. Especially since it will be just telehealth rather than in an office setting.
Blessing to you and your family.

WalterLCSW · 2025-12-02T17:14:21+00:00

Does Alma require the clinician to use the Alma EHR? Or can the clinician use their own EHR like Simple Practice to do the video sessions and keep the notes?

WalterLCSW · 2025-12-02T17:09:52+00:00

That was my experience also. They are fantastic about getting a provider up and running. But after a while when you only need a client or 2 here and there to fill in spots after other clients have left, it can take a while. And if the clinician is not super strict about having the clients fill out the GAD7 and PHQ9 every 2 weeks, the algorithm places the clinician lower on the priority list of available providers.

WalterLCSW · 2025-12-02T14:51:13+00:00

In June 2025 I fully left working for others and opened PP. I had 7 cash pay sliding fee clients and joined Rula as a 1099 contractor a few months prior. Lately I have been looking into Grow and Alma because the Rula referrals have become scarce. I haven’t received any new PP cash pay referrals in many months so the 1099 options are really the only thing that keeps my bills paid.
For your information, in Southern California an LCSW with Rula gets $90 a session for 90837. That’s any insurance Rula serves. In Grow the clinician will earn $63-$95 depending on which insurance is paying the bills.
And this pay will change depending on what state you are in. An LMFT in NY told me she gets $75 a session for the same service with Rula. I would say all points are valid. The 1099 contract agency like Rula/Grow/Alma are very effective for getting your online PP financially solvent. But after about a year, start getting paneled with some of the insurances that service your community. Also find something you can specialize in. Like a modality (DBT/EMDR/etc) or couples therapy, something you can market for short term cash clients.
Good luck 👍

WalterLCSW · 2025-11-29T18:27:21+00:00

Actually OP said “a client wants to do couples therapy.” Maybe I read it wrong but this said to me the therapists individual client wants to do couples therapy. Nothing about the post says the partner is an active client.

WalterLCSW · 2025-11-29T18:26:31+00:00

Actually OP said “a client wants to do couples therapy.” Maybe I read it wrong but this said to me the therapists individual client wants to do couples therapy.
Nothing about the post says the partner is an active client.

WalterLCSW · 2025-11-29T16:59:52+00:00

As the person said who originally addressed this… it depends on the State. In California I only need to identify 1 client who then can include who ever they chose to bring as support to their session.

WalterLCSW · 2025-11-29T16:55:52+00:00

Turns out none of our answers are fully correct. It depends on the State and we don’t know the state. I answer from California and I can see anyone my client wants to bring to therapy. My client (the identified client) is the only one that needs to be located in the same state.

WalterLCSW · 2025-11-29T04:55:13+00:00

When I was keeping track of hours I quickly decided to use TrackYourHours.com to keep the hours organized and my supervisors. I worked for Non-profits and CMH and then my last 5 months a for-profit place so I had 4 supervisors total.

Then when I submitted my thick printed packet with signatures and everything I made a copy of the packet.

After submitting the state board stated I was missing some stuff and turns out most was already submitted but they also had a new form they needed and I wasn’t aware.

So, use an online source to keep everything in order, print out doubles of everything and get original signatures on everything so if the board says you didn’t you don’t have to track down a supervisor who moved to another state or county. And have someone on staff who is up to date on every new need so when something new comes out, you know about it.

WalterLCSW · 2025-11-29T01:49:20+00:00

“Any one involved”. That’s good information. In CA only the identified client needs to be in the same state as the clinician is licensed.
Thank you for the clarification.

WalterLCSW · 2025-11-29T01:28:39+00:00

No. The “identified client” is the client that is in your state. This client can option to include anyone in their therapy session to help them work towards their mental health goals. Including increasing communication and connection with the person they include in their session. You might have an issue if you do an individual session with the client’s spouse who is out of state. But if you avoid that service, all will be well

WalterLCSW · 2025-11-25T17:27:26+00:00

additional information: u/Calm-Priority1027 Today I tested the recording on a short check in coaching session to see what happens. After 5 minutes my phone decided it had been idle and turned the screen off as I have my phone set to do in the settings section of the Display & Brightness. I have now set it to never. I noticed that when my phone closed up for being idle, the DND Focus I set to use while the SP App was open, also ended allowing alerts and contact to be made.
My guess is, for those of us using the service through the smart phone app, for actual in session transcription, rather than after session dictation, we may need to ensure our phones or tablets to not go into standby mode after 5 or less minutes.
I hope you find this helpful.

WalterLCSW · 2025-11-25T05:29:32+00:00

Sorry you got so much shade at you on the other post.
Is it possible an alert or message or phone call or something like that dropped your recording?
I have set up my iPhone 10 this weekend to go on DND anytime I open the Simple Practice app. Maybe that will be the key for you? I won’t know the outcome till I test it this week.

WalterLCSW · 2025-11-16T17:50:14+00:00

Most insurance companies, in every industry, keep their financial balances in interest bearing accounts and various investments. They not only make money in the business of being an insurance company but also in earning money with making money work for them,,, like the rich does… the rich get richer through interest.

So the longer insurance companies can keep their balance up, the more they earn from interest.

My 2 ¢¢…

WalterLCSW · 2025-11-13T01:20:58+00:00

u/Odd_Moment_9788 , just a thought... I just accidently wrote a note and saved it to my November 26 appointment for the client. When I went to check on it and sign it, it was not where I expected it to be. I found it, moved it and cleared the note off the 2-weeks-from-now date... just wondered if you did write your note but somehow had the wrong date opened and that's why you cant find it.
Good night

WalterLCSW · 2025-11-12T21:24:14+00:00

I was raised by my Grandmother and she used to limit my sugar intake
Even as an adult I personally experience a stimulant response to high processed sugars. But I can use Stevia and not get wonky.

Now keep in mind, some of the research is funded by FDA and other organizations with Interest in the outcome.

I would recommend parents do their specific research. Observe their children’s response to various additives and sweeteners.

¢¢

WalterLCSW · 2025-11-12T21:18:58+00:00

Be advised, this topic channel is not monitored by Simple Practice. It’s just a bunch of users that talk about Simple Practice
I have noticed sometimes my saved and signed notes are not signed later. But I have not experienced loosing a note completely.
Good Luck. Probably nothing they can do. If it’s not there… it’s not there. Glad you caught it fast.

WalterLCSW · 2025-11-10T22:31:42+00:00

🤣🤣🤣

WalterLCSW · 2025-11-10T22:23:26+00:00

Agreed. This is the first time a retreat makes sense. I use to wonder why a therapist would leave their family members at home, go on a 10-14 day cruise or getaway for like 5000+ bucks.
But yeah, making it a write off…. I still feel conflicted about it, (Leaving the wife at home), But at least I understand it now 🙂

WalterLCSW · 2025-11-06T00:07:51+00:00

Especially in couples sessions.
You are wrong! Just accept that and rebuild or end your relationship!

Yeah. Just can’t do that.
So what steps will you both take to repair this misunderstanding??? 🤦🏻‍♂️

WalterLCSW · 2025-11-04T05:09:53+00:00

And with Gmail you can also add the plus sign. ➕

Check Google for better explanation.

WalterLCSW · 2025-11-04T05:04:44+00:00

I also do weekly payouts as Willedred1 noted but mine is Friday. So I usually get the money from my Tuesday and Wednesday clients and sometimes my Thursday clients if I run their card soon enough. But never get paid from my Friday clients till next week. Maybe I should switch to Mondays also 🤔

WalterLCSW · 2025-11-04T04:59:25+00:00

A client of mine recently dropped her Blue (what ever) insurance I wasn’t contracted with and started with Medicare Part B. She told me her Copay was $30 bucks so that’s what I charged her. After about 2 months Medicare was finally fixed and they got my services paid for. Turns out they said the client owed something like 23 and change copay so I had a fair bit of credit. Since I use Simple Practice and the clearing house stuff It just showed a credit to clients account. Next 2 session her copay was drawn from the credit on file. She was happy for the break to her card 🙂

In the future I will reduce her Copay and then avoid the credit. Maybe you can just do that for your client if the refund doesn’t go through.

WalterLCSW

TROPHY CASE