Payroll for therapists and group practices, per session or salaried

What our payroll work covers

As part of Full Service Partner, we can run the whole payroll cycle, from session data to paid clinicians, on the payroll platform your practice already uses. That can include:

• Clinician pay calculated from session-level data in your EHR, with supervisor hours logged separately.
• Salaried pay, and prorations when someone starts or leaves partway through a period.
• Each payroll cycle, plus off-cycle payments.
• Answers to clinicians' pay questions.
• W-2 and 1099 administration, with 1099 processing at no additional charge.
• Year-end forms, benefits deductions, 401(k) sync, and PTO and sick-time accruals.

Start with each person's approved pay agreement

Payroll starts with how each person is supposed to be paid. A practice may pay a salary, a rate per completed session, an hourly rate, or pay based on money collected. Follow the approved agreement for that person and period. The easiest report to download may not use the right rules.

List the work that should be paid, the rates and when they took effect, the pay-period dates and where each input comes from. Include approved nonclinical work, leave and other payable items. A completed-session total is usually only one part of the pay agreement.

We apply that agreement at each step, from the source records to the calculation, your approval and the payroll run, and we keep a clear record of each calculation. Your practice keeps compensation decisions and approval authority.

Per-session pay, salaried pay and supervisor hours

Per-session pay is calculated from completed sessions in your EHR, multiplied by each clinician's approved rate, with supervisor hours added at their own rate. We take the session-level data for the pay period, apply your rules for which sessions are paid, and use the rate in effect on each session date. Supervisor hours are logged separately, so supervision time is paid at the supervision rate and kept apart from session counts. Salaried clinicians are paid their salary for the period. A clinician who starts or leaves partway through a period is prorated by the method your practice sets. Before anything runs, you see the totals, the sessions behind them and any exceptions. In the example below, 30 sessions at $70 and 2 supervision hours at $40 come to $2,180. The rates are invented for the example and are not a pay recommendation.

For the salaried rows, $62,400 ÷ 26 pay periods is $2,400. A new hire who works 6 of the period's 10 workdays is paid $2,400 × 6 ÷ 10, or $1,440. Some practices prorate by calendar days instead. The method is your policy, and we apply it the same way every cycle. The full payroll also includes taxes, deductions and employer costs, which the example leaves out.

Keep session dates, payment dates and pay periods clear

A session can happen in one pay period and be paid for in another. Which date matters depends on the pay agreement. Per-session pay uses the session date. Pay based on money collected uses the payment records the agreement names.

EHRs track these dates separately. Jane, for example, tracks four dates. The purchase date is when the session took place, and the invoice date is when its invoice was issued. The received-at date is when payment arrived. The applied date is when that payment was matched to an invoice. Those dates can put the same session in different pay periods, so we check which one a report uses before we calculate pay.

Changes after the cutoff need a record too. For a corrected appointment, a late payment, a refund or a rate change, keep the original approved result and add the correction through your approval process. Overwriting last period's workbook makes the next pay question harder to answer.

How payroll connects to billing and session data

Payroll in a therapy practice runs on the same session and billing records as the rest of the practice. The session a clinician completes is the one that gets billed and paid, so a session recorded wrong makes both the claim and the paycheck wrong. If pay depends on collections, payroll waits on claims being paid and posted. When our billing team also files and follows your claims, a pay question that starts with a denied or unposted claim goes to the people who can fix the claim. Practice Analytics, included with Full Service Partner, shows sessions, revenue, attendance, caseloads and clinician performance, so you can see the numbers behind payroll without asking for a report. When something needs correcting, we fix the record where the error started and carry the approved change into payroll.

Fix repeated problems at the step where they start. That can mean a reliable way to record approval for supervision hours, an updated pay record when a rate's start date is unclear, or a check of the numbers before the next run when reports disagree.

Calculate pay, get approval and run payroll

Each cycle follows the same steps, so the calculation stays visible and exceptions reach the right person before the deadline.

1. Gather the records

   Pull the period's completed sessions, supervisor hours, salaries and other approved pay items.

2. Calculate pay

   Apply each person's approved rates, dates and rules.

3. Check the totals

   Compare them with the source records and pay agreements.

4. Resolve questions

   Bring the facts and the decision needed to the right person.

5. Get approval

   Present the totals and changes to your authorized approver.

6. Run payroll

   Run the approved payroll on your existing payroll platform.

7. Keep the record

   Confirm the run and keep the approved result.

W-2 employees and 1099 contractors

We administer payroll for W-2 employees and 1099 contractors, and 1099 processing is included at no additional charge. Deciding which one a clinician is stays with your practice and its advisers.

The IRS stresses that business owners need to correctly determine whether the people providing services are employees or independent contractors. It says all evidence of the degree of control and independence must be considered, and it groups that evidence into behavioral control, financial control and the type of relationship. Payroll administration applies the classification your practice has set.

Answer payroll questions without rebuilding the calculation

When a clinician asks about pay, the answer should trace to their pay period, their sessions and their agreement. We answer routine pay questions from the calculation and the payroll record, and we flag anything that needs correcting.

Questions that would change pay policy go back to your practice's decision-maker.

Keep a record when something changes

Set an input cutoff and a clear process for late information. For each change, record the period it relates to, why it changed, the source that supports it and who approved it. The person reviewing payroll should see the correction without comparing several nearly identical spreadsheets.

The IRS tells employers to keep employment tax records for at least four years after filing the fourth quarter for the year. Those records include the amounts and dates of all wage payments. A clear payroll record is part of meeting that obligation, and your practice still keeps its own records.

What stays with you

We apply your payroll decisions, and these stay with your practice:

• Hiring and termination.
• Whether a clinician is a W-2 employee or a 1099 contractor.
• Pay rates, pay models and any change to them.
• Approval of each payroll run and any off-cycle payment.
• Wage, tax and benefit questions that need your accountant or attorney.

Payroll inside Full Service Partner

Payroll is one part of Full Service Partner, our membership. Cortexa is an operations team for independent therapy practices that runs the front desk, intake, billing, credentialing and payroll as one team. When we also run intake and billing, the session we book and bill is the same session we use to calculate the clinician's pay.

Billing runs about 3% of what you collect, and the front desk, intake and billing together about 6%. We agree the exact scope and rate before you start, and you can start with only the work you need most. Practice Analytics is included at no extra cost. On its own it costs $50 a month.