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Free practice calculator

Mental health billing cost calculator

What will this billing quote cost each month, as a share of what you actually collect?

What does your practice bill each month?

Use a typical month of insurance sessions.

Insurance sessions billed each month

Count sessions billed to insurance, including the client's share.

Average allowed amount per session

The insurer's agreed fee for a session. It includes the client's copay, coinsurance or deductible.

Share of claims the insurer pays

percent

Claims that end up paid after rejections are fixed. Leave out denials that are never overturned.

Share of the allowed amount you collect

percent

Insurance payments plus the client's share you actually receive, as a share of the allowed amount.

How does the billing company charge?

Enter the fee exactly as the billing company states it.

What is the fee based on?

Percentage in the quote

percent

The rate the billing company quoted, for example 7 for 7%.

Clinicians billed

Clinicians whose sessions this company would bill.

Monthly fee per clinician or NPI

Some companies add a monthly fee per clinician, tax ID or NPI. Enter zero if there is none.

One-time setup or onboarding fee

Enter zero if there is none.

What would doing it yourself cost?

Enter what a biller on your own payroll would cost for the same work.

Biller hours per week

The hours an in-house biller would need for the same work.

Hourly pay

The rate you would pay a biller where you hire.

Employer costs on top of pay

percent

Payroll taxes and any benefits, as a share of pay.

Billing software and clearinghouse per month

Enter zero if your EHR already includes claims.

Your numbers stay in this browser.

Monthly cost of this quote

$2,554

$2,554 a month, 7.2% of what you collect

This quote charges a percentage of the allowed amount on paid claims. Balances you never collect still carry a fee. An in-house biller at the hours and pay entered would cost $2,596 a month, $42 more.

Where the money goes

Allowed amount billed: $38,400
Allowed amount on paid claims: $36,480
Amount collected: $35,328
Fee on the quote's basis: $2,554
Per-clinician fees: $0
Monthly cost of the quote: $2,554
One-time setup fee: $0
First-year cost of the quote: $30,643
In-house pay (hours × pay × 52 ÷ 12): $2,080
Employer costs on that pay: $416
Billing software and clearinghouse: $100
In-house biller each month: $2,596

Share of what you collect: 7.2%
Cost per insurance session: $7.98per completed session
In-house biller each month: $2,596

Calculation details

Monthly amounts use 52 weeks ÷ 12 months. The in-house estimate covers pay, employer costs and software. It leaves out hiring, training, cover during time off and your time managing the work. A quote can also carry minimums, credentialing fees or charges for older claims. Add those before you compare.

Share of what you collect: 7.2%
Cost per insurance session: $7.98per completed session
First-year cost, including setup: $30,643
Collected each month: $35,328
In-house biller each month: $2,596
Quote minus in-house: -$42.4

Monthly cost compared

Billing company quote$2,554

In-house biller$2,596

How the calculation works

Allowed amount billed = sessions × average allowed amount. Fee = rate × allowed amount on paid claims, or rate × amount collected, or the flat fee, plus per-clinician fees × clinicians. Share of what you collect = monthly fee ÷ (allowed amount billed × share collected) × 100. In-house cost = hours × hourly pay × 52 ÷ 12 × (1 + employer costs) + software.

A typical month is used for every amount. Seasonal changes and deductible resets early in the year change the collected share.
The in-house estimate covers pay, employer costs and software. It leaves out hiring, training, cover during time off and the owner's time managing the work.
A quote can carry terms this calculator doesn't model, such as minimums, credentialing fees, patient-statement postage or charges for older unpaid claims. Add them before comparing.

Compare quotes on the same basis

Two quotes with the same percentage can cost different amounts. A fee on the allowed amount includes balances you never collect. A fee on what's collected moves with what you actually receive.

Enter each quote in turn and compare the share of what you collect. That number lets you compare a percentage quote with a flat fee.

What the in-house number leaves out

A biller on your payroll costs more than hourly pay. Someone has to hire, train and check their work, and claims still need attention when they're away.

The calculator counts pay, employer costs and software. It can't count your hours spent managing the work, so add those yourself.

Questions to ask with the quote

What counts as collected?

Ask whether client payments, refunds and payments on older claims are included in the fee.

What's extra?

Ask about setup fees, per-clinician fees, credentialing, statements and work on claims from before the start date.

What starts before the claim?

Ask who checks eligibility and benefits at intake. Many denials start with details collected before the session.

Common questions

Is a percentage of allowed or a percentage of collected cheaper?

At the same rate, a fee on what's collected costs less whenever part of the allowed amount goes uncollected. Enter both versions of a quote to see the difference for your practice.

How do I compare a flat fee with a percentage?

Choose the flat fee option and compare the share of what you collect. If your collections grow, recheck the result, because a percentage fee grows with them and a flat fee does not.

What hourly pay should I use for an in-house biller?

Use what you would actually pay where you hire. Our billing cost guide lists published wage data you can start from.