Private Practice vs Group Practice

It’s 4:10pm. Priya has a group offer in one tab and a lease draft in the other. Private practice vs group practice is the card above, not a jobs listing. Software for one clinician sits on the solo therapist page. Software for a group that already has more than one clinician sits on the group practice page. Neither page fills the rows.

Fill every row before you sign. A blank exit row means you have not decided.

Priya is not building a group this month. The build column stays a template until she is. Her filled card, from the offer and the lease draft, looks like this.

Educational resource for licensed mental-health clinicians in US practice. Plan rules, board rules, and contracts change. This card is not legal advice, not a fee survey, and not a state supervision chart.

What private practice vs group practice decides

The click you wanted was a percent. The decision in front of you is smaller, and it has six parts. Who pays you. Who sets the work. Whose identifier the plan has. Whether a named person supervises you. Which entity holds the chart. What the paper says if you leave.

That is not the startup sequence. Once you choose solo, the order of the lease, the entity, and the first payer application lives on the startup checklist for a solo practice. Come back here only if you are still choosing. A group that already exists, and wants software rather than this decision, is the other hub linked above.

Priya almost signed because the 60 percent looked clean. Clean is not the same as filled in. Two of her rows are still open. Those two are the decision.

Pay model

What number are you actually comparing on a private practice vs group practice card?

Write the line from the document, not the line you hope is typical. This page will not give you a usual split. A blog average is not her offer, and it is not yours. Priya’s group line is 60 percent of collections. Her solo line is not 100 percent. It is collections minus a $1,850 lease, minus billing help she has not priced, minus the malpractice premium she has not opened. A higher percent can be a smaller check. You cannot see that until both sides have numbers.

Write the label too, on the same row, and do not treat it as the pay. The offer may call you an employee or a contractor. That word is not the dollar line. This page does not tell you which label is the correct one for your facts. Copy the word that is printed, then copy the percent, the salary, the hourly rate, or the owner draw. If the dollar line is missing, the row is open.

If you are building, the pay row is the offer you will make, not the offer you received. Write what the entity collects, what you draw, and what you will pay the next person. A blank draw is not an owner plan. It is a wish.

Clinical control

Priya’s offer lets her keep her modality. It also assigns every new client. Those are not the same fact, and a single word like “autonomy” hides the split.

Write four items, separately. Who sets the caseload. Who sets the modality. Who sets the session length. Whether you can decline a client. Solo, you hold all four, and you also hold the Thursday that does not fill. Joining, copy the offer. If the offer is silent on a decline, that item is open. Do not fill it with a feeling you had on the tour.

Building is the same four items, written as rules you will keep when a second person starts. If you already know you will assign every new client and call it shared control, write that. The card is for the rule you will actually use.

Credentialing path

On a private practice vs group practice card, this row is whose identifier the plan has, and who files. It is not a product ranking, and it is not the filing checklist.

The CMS NPI Fact Sheet, December 2024, draws the line. Type 1 is for individual health care providers, such as physicians, nurse practitioners, and sole proprietors. Individuals are only eligible for one NPI. Type 2 is for health care organizations, such as hospitals, nursing homes, and physician groups. Organizations can have multiple NPIs. An individual who is a health care provider and is incorporated can obtain an NPI for themselves (Type 1) and an NPI for their corporation or LLC (Type 2).

Read that against the three columns. Solo and unincorporated: your Type 1, and you write who submits each plan. Solo and incorporated: your Type 1, and the Type 2 the corporation or LLC may obtain. Write who submits that application. Joining: your Type 1 stays yours. Write the group’s Type 2, and write who submits each plan. Building: your Type 1, and, if the organization is incorporated, the Type 2 it may obtain. Write who submits each application. A Type 2 is not a reason to join someone else’s group. The fact sheet says an incorporated individual can obtain one for a corporation or LLC of their own.

Having an NPI does not finish the row. The same sheet says having an NPI does not ensure a provider is licensed or credentialed, guarantee payment by a health plan, or enroll a provider in a health plan. Health plans, including Medicare, Medicaid, and private health plans, require an NPI in administrative and financial transactions. That is the identifier. It is not the contract.

Medicare is a separate sentence, and only if you bill Medicare. The fact sheet says an NPI is required for Medicare enrollment, and that obtaining an NPI does not replace the Medicare certification or enrollment process. A provider or supplier will not receive payment from Medicare until it is properly certified and enrolled. An update to the NPI record in NPPES does not automatically update Medicare enrollment information. Write whose Medicare enrollment the claim would ride on. Do not assume the group’s enrollment covers you because you have a Type 1.

If you are a covered health care provider, the same sheet says you must report any changes to the information provided for your NPI within 30 days of the change. A new practice address is a change. Put the date you will file it on the row, or the row is not done.

Who walks the application into each commercial plan is still a name you write. The steps for that filing live on insurance credentialing for therapists. This page does not repeat them. Priya’s open item is the list of plans the group will not file. Until she has that list, the group column is a slogan.

Supervision

“Supervision available” is not a supervisor of record.

Write the person’s name, whether your current license status requires one, who pays for the hour, and whether the hour is clinical or administrative. This page does not list state hour rules. Those sit with your licensing board. If you have not checked that board for your current status, write “not checked.” Do not write “none required” from memory of a classmate’s license.

Priya’s offer uses the available phrase and names no one. Her solo column says none found, and she still has to recheck the board site before that cell is a yes. The group cell stays open until it has a name. A group that will not name the person has not offered supervision. It has offered a sentence.

If you are building, this row is about the people whose license status requires a named supervisor, not about a job ad. Write the name before they start. Hiring searches are a different job. They are not this card.

Who holds the chart

Record ownership on a private practice vs group practice card is a name you copy from the agreement, plus the federal access rule that does not pick a winner.

45 CFR 164.501 defines a designated record set as a group of records maintained by or for a covered entity that is the medical records and billing records about individuals maintained by or for a covered health care provider, or records used, in whole or in part, by or for the covered entity to make decisions about individuals. For that paragraph, a record is any item, collection, or grouping of information that includes protected health information and is maintained, collected, used, or disseminated by or for a covered entity.

45 CFR 164.524 then says an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a designated record set, for as long as the protected health information is maintained in the designated record set, except for psychotherapy notes, and except for information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.

Psychotherapy notes, in 45 CFR 164.501, means notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record. The definition excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

So the access right is the individual’s. It runs against the covered entity that maintains the set, for as long as that entity maintains it. It is not a deed that says you own the file, and it is not a deed that says the group owns the file. Notes that meet the psychotherapy-notes definition, and that you keep separate from the rest of the medical record, sit outside that access right. The chart the individual can request is the designated record set. Write which entity maintains it.

Priya’s group line says the chart stays with the group. That is a contract sentence, not a HIPAA conclusion. Her open item is whether she can get a copy if she leaves. The regulation answers a different question: the individual can request access from the entity that maintains the set. Her own copy, and any psychotherapy notes kept apart from that set, are what the contract has to speak to. If the contract is silent, the row is open.

One clock is easy to mix up. 45 CFR 164.524 says the covered entity must act on a request for access no later than 30 days after receipt of the request, aside from the extension that same paragraph allows. That clock starts when the individual asks. It is not your resignation notice. Priya’s notice is 90 days because the offer says 90 days. Do not borrow the access clock and call it your exit.

Exit terms

Copy four lines, or admit you have not read them. Notice. Who keeps the chart. Tail coverage, with a premium if the policy names one. Any non-compete or non-solicit you would actually sign.

This page does not say which of those a state will enforce. Enforcement is not a number I can hand you. The card asks what the paper says. Priya has a 90-day notice and a non-solicit on the group side, and a 60-day notice on the lease. Both tail lines are blank. She does not sign while they are blank. A blog that says “groups usually cover tail” is not her policy. Open the policy, or leave the row open.

If you are building, these are the terms you will offer, written before the first person starts. A handshake exit is a blank row.

After the card is full

If the solo column is the one you can fill, stop comparing and open the startup checklist. That page is the sequence. This one was the choice.

If the join column is the one you can fill, take the card into the signing meeting. A row that still says “available” or “we’ll send that” is not filled. Ask for the page that has the number, the name, and the chart sentence.

If you are building, the card is the offer, not a mood. Pay, control, credentialing, supervision, the chart, and exit, written before anyone else depends on them. The group software page does not make that choice. It assumes you already have.

Fill the private practice vs group practice card before you sign the lease or the offer. Two open rows is not a decision. It is a Friday you should still be on.