I build SoloAgent, the launch copilot for therapists going solo. I'm not a therapist. This article covers business planning and draws on the public research linked below.
Before you open your doors, three business questions are worth answering with your own numbers, not a national average.
Will your ideal client's insurance actually pay you?
Affordability shapes who walks in the door. In a Gallup poll conducted February 2-14, 2024, 52% of U.S. adults named cost as a potential barrier to getting treatment for a mental or emotional health condition, roughly six in ten among adults under 50, versus 35% of adults 65 and older (Gallup, 2024). That's one point-in-time poll, not a trend line, but it's a reason to expect prospective clients to ask about your fees and what your panels cover before they book a first session.
Telehealth is part of that access picture too, though the data is narrower than it looks. A KFF survey of state Medicaid programs, fielded in 2022 and published January 2023, found states reporting that behavioral health telehealth utilization had declined from its pandemic peak but remained well above pre-pandemic levels (KFF, January 2023). That's Medicaid specifically, not private-pay practice broadly, and it doesn't tell you whether telehealth is still the default intake channel in your market in 2026. Check your own referral sources for whether they expect telehealth, in-person, or both.
If you plan to accept Medicaid, check your state's current behavioral health fee schedule and the relevant plan's participation requirements. Use those terms in your budget.
How will referral sources know whom you serve?
A quick search of your specialty and zip code on a directory like Psychology Today will show you how many other therapists are already listed there. That's a rough scan of visible supply, not a measure of whether your local market is saturated. It doesn't count therapists who aren't listed, and it says nothing about demand.
Describe clearly whom your practice serves so a referral source, a physician, another therapist, an agency, can assess fit quickly. A generalist listing ("individual therapy for anxiety and depression") gives a referral source less to go on than a specific one. That's a positioning choice, not a data-backed prediction about how fast you'll fill a caseload.
For an in-person practice, keep your practice address consistent across your website and directories. Check Google's eligibility rules before creating a Business Profile. For telehealth, clearly state the states you serve and the relevant payer participation details.
What does it take to get in-network, and how long will it take?
Credentialing timelines vary by payer and by state, and they aren't fully predictable from public data. Ask each payer directly whether its panel is open, what documents it requires, and when your participation can become effective once you apply. Build the confirmed steps and dates into your launch plan rather than assuming a standard timeline, and start the process as early as your license and business setup allow.
What to do next
Before choosing your launch date, write down three things: the payer participation and reimbursement terms you're considering, the referral sources you can contact, and each payer's enrollment steps and quoted timing. Mark what you've verified and what still needs an answer. Use that list to choose your next action.