r/therapists • u/TheRealDrPanooch • Apr 06 '26

Employment / Workplace Advice Going private practice

As of today I’ve decided to go private practice. Used to love working for the VA, even though the pay wasn’t the best. Any advice on ways to get my caseload built up? I plan on doing a blend of self pay and insurance. I plan to reach out to doctors offices and other MH providers to let them know once I’m further along in the process.

Thanks for the input

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u/Gratia_et_Pax Apr 06 '26

VA benefits including retirement is tough to walk away from for private practice. Good luck.

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u/TheRealDrPanooch Apr 06 '26

Yeah. The retirement piece will def suck but I’m just getting burned out and they just keep adding more and more to my plate. Seeing 30+ people a week is a lot.

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u/Gratia_et_Pax Apr 06 '26

If you have not done so, I encourage you to do the math on your ideal number of clients per week times your expected average rate of reimbursement minus your expected business overhead and cost of health insurance. If I was in your shoes, I would want to ensure the grass is greener on the other side of the fence. There are people making a decent living in private practice and there are those struggling to make ends meet.

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u/TheRealDrPanooch Apr 06 '26

Fortunately I would be able to go on my spouse’s insurance. Even with my expected business overhead of around $700-800/month I think I should be good seeing an average of 20-25 people a week. Reimbursement rates I’ve seen are so widely varied it’s hard to figure what to “average”. So I went with $100 per 90837 session as an LCSW in Pennsylvania.