**Productivity rate formula**: (Billable clinical hours) ÷ (Total work hours) × 100 = **Productivity %**. **Industry benchmarks (2025 SimplePractice/TherapyNotes data)**: **60-65%** = minimum acceptable productivity for employed therapists (agency/hospital setting). **70-75%** = good productivity for private practice. **80-85%** = excellent productivity (efficient systems, minimal admin). **>85%** = unsustainable burnout risk (insufficient documentation/planning time). **<60%** = concerning, indicates scheduling issues, high cancellations, excessive admin time, or inefficient systems. **Example calculation**: 40-hour work week. 28 billable client hours, 6 hours documentation, 4 hours scheduling/admin, 2 hours marketing = **28 ÷ 40 = 70% productivity** ✅ Good. **Billable vs non-billable breakdown**: **Billable hours** (revenue-generating): Individual therapy sessions, couples/family therapy, group therapy sessions, psychological assessments/testing, case management (if billable to insurance). **Non-billable hours** (necessary but unpaid): Clinical documentation (progress notes, treatment plans, discharge summaries), insurance authorizations/verification, scheduling/rescheduling, billing/collections, supervision (giving or receiving), continuing education, marketing/networking, administrative tasks. **Typical time allocation (private practice)**: 30 client hours/week (billable), 6 hours documentation (2 hours billable if included in session rate), 2 hours insurance/billing, 1 hour scheduling, 1 hour professional development = **30 billable ÷ 40 total = 75% productivity**. **Setting-specific benchmarks**: **Private practice solo**: 70-80% (more control, fewer meetings). **Group practice employee**: 65-75% (staff meetings, group coordination). **Community mental health**: 60-70% (more documentation, case management). **Hospital/inpatient**: 55-65% (team meetings, multidisciplinary coordination). **Telehealth**: 75-85% (less commute/setup, back-to-back scheduling easier). **Part-time (<30 hours)**: 50-65% (harder to fill slots consistently, more overhead per hour).

**Strategy #1 - Optimize scheduling (5-15% productivity gain)**: **Back-to-back sessions with breaks**: Schedule sessions in blocks (4 sessions, then 30-minute break for notes/lunch), reduces context-switching and downtime, allows focused clinical time, 10-minute buffer between sessions prevents running over. **Example**: Old schedule: 9am, 11am, 2pm, 4pm (4 sessions, lots of gaps) = 4 clinical + 6 hours gaps/admin = 40% productivity.

New: 9am, 10am, 11am, 12pm, break, 1:30pm, 2:30pm, 3:30pm, done at 4:30pm (7 sessions in 7.5 hours) = **93% productivity during clinical blocks**, overall 70% for day. **Consistent schedule**: Same days/times each week (Mon 9-5 clients, Tue 9-5 clients, Wed admin/notes, Thu-Fri clients) reduces no-shows (clients remember routine), easier to fill cancellations (consistent slots), better work-life boundary (Wed always admin). **Strategy #2 - Reduce no-shows and cancellations (10-20% productivity gain)**: **No-show rate** kills productivity (national avg 15-25% for therapy). **Reminder system**: Text/email reminders 24-48 hours before session (reduces no-shows 40-60%, TherapyAppointment/SimplePractice auto-reminder feature). **Cancellation policy**: 24-48 hour notice required or charge full fee, enforced consistently (first time warning, second time charge), reduces last-minute cancellations from 25% to 5-10%. **Waitlist management**: Maintain list of clients wanting earlier/additional slots, fill cancellations same-day (text blast to waitlist "9am tomorrow available, first response gets it"), recover 50-70% of cancellations. **Result**: 25% cancellation rate → 10% = gain 6 billable hours/week on 40-hour schedule = productivity 60% → 75%. **Strategy #3 - Efficient documentation (save 5-10 hours/week)**: **Templates and macros**: Pre-written treatment plan templates for common diagnoses (depression, anxiety, trauma), copy/paste progress note structure, fill in session-specific details only, reduces 20-minute note to 5 minutes. **Immediate notes**: Complete notes right after session while fresh (5-10 minutes), vs end of day (15-20 minutes trying to remember details), or worse end of week (30+ minutes reconstructing from memory). **Voice-to-text**: Dictate notes using phone/computer speech recognition (Google Docs voice typing, Dragon software), speak faster than type (150 words/min speaking vs 40 typing), edit dictation takes 3 minutes vs 15 typing. **EHR shortcuts**: Master your software (SimplePractice, TherapyNotes, ICANotes) keyboard shortcuts, create custom templates, use quick-entry fields, batch similar tasks (all notes Monday, all billing Friday). **Time saved**: 15 min/note × 30 clients = 7.5 hours/week → 5 min/note × 30 = 2.5 hours/week = **save 5 hours** = add 5 more client hours = productivity 60% → 73%. **Strategy #4 - Leverage group therapy and workshops (30-50% revenue increase per hour)**: **Group therapy**: 6-8 clients × $60/person = $360-480/hour revenue vs $120-150 individual session, still counts as 1 billable hour, 3-4× revenue per clinical hour, insurance often covers (check individual policies), topics: CBT skills group, DBT, grief, parenting, social anxiety. **Workshops/psychoeducation**: Evening or weekend workshops (4-hour "Managing Anxiety" workshop, 15 participants × $100 = $1,500 for 4 hours = $375/hour), one-time prep reused quarterly, expands reach and revenue, not all insurance-billable but cash-pay popular. **Strategy #5 - Reduce administrative burden with automation**: **Online scheduling**: Clients self-book using Calendly/Acuity/SimplePractice integrated scheduler (saves 2-3 hours/week of phone tag), auto-sync with Google Calendar, send auto-reminders, reduce scheduling calls/emails 80%. **Auto-billing and insurance**: EHR auto-submits claims to insurance (weekly batch), auto-charges client credit card on file for copays, auto-generates superbills for out-of-network, saves 3-5 hours/week vs manual billing/invoicing. **Hire admin assistant (VA)**: Virtual assistant at $15-25/hour for 10 hours/week ($150-250/week) handles insurance verification, scheduling, billing follow-up, frees 10 hours/week for you, add 8 billable client hours = $960-1,200 revenue, net profit $710-1,050/week (**$2,840-4,200/month**) after VA cost. **Combined impact example**: Therapist earning $100/hour clinical, 60% productivity (24/40 hours billable) = $96k/year ($2,400/week × 40 weeks).

Implement 5 strategies: +5 scheduling hours, +6 no-show recovery, +5 documentation time, +4 admin automation = **add 20 hours/week capacity**, fill 15 with clients = 39 billable/40 total = **98% productivity** = $156k/year (+$60k, 63% increase) in same 40-hour week ✅.

**Gross revenue per hour**: Total session fee charged (cash-pay rate or insurance reimbursement rate) before any expenses.

Example: Individual therapy session $150/hour = **gross $150/hour**. **Net revenue per hour**: Actual take-home income after deducting all expenses. **Formula**: (Gross revenue) - (Direct costs) - (Overhead) - (Taxes) = **Net revenue**. **Expense breakdown (private practice 2025 typical)**: **Direct costs (15-25% of gross)**: Credit card processing fees 2.5-3.5% ($150 × 3% = $4.50/session), EHR software ($50-150/month ÷ 100 sessions = $0.50-1.50/session), malpractice insurance ($1,200/year ÷ 1,500 sessions = $0.80/session), liability insurance, continuing education ($800/year ÷ 1,500 = $0.53/session). **Overhead (20-35% of gross)**: Office rent ($800-2,000/month ÷ 100 sessions = $8-20/session), utilities ($100-200/month ÷ 100 = $1-2/session), internet/phone ($150/month ÷ 100 = $1.50/session), furniture/decor ($3,000 amortized ÷ 3 years ÷ 1,500/year = $0.67/session), office supplies ($50/month ÷ 100 = $0.50/session), professional memberships ($300/year ÷ 1,500 = $0.20/session), marketing ($500/month ÷ 100 = $5/session or $0 if waitlist). **Taxes (25-35% of profit)**: Self-employment tax 15.3%, federal income tax 12-24%, state tax 0-13%, total effective 25-35% on profit. **Example calculation (solo private practice)**: Gross $150/session.

Direct costs $7.33.

Overhead $36.87.

Subtotal expenses $44.20.

Profit before tax $105.80.

Taxes 30% = $31.74. **Net revenue = $74.06/hour** (49% of gross). **W-2 employed therapist**: Gross $60/hour (employer keeps $90, pays you $60).

No direct costs or overhead (employer covers).

Still pay income tax 20-25% = $12-15. **Net revenue = $45-48/hour** (75-80% of gross hourly). **Break-even analysis**: Need 35-40 billable hours/week to match W-2 salary of $60k ($1,154/week ÷ $74 net/hour private practice = 15.6 hours/week break-even for same take-home, but need 35-40 hours total including non-billable to generate those 15.6).

At 70% productivity, need **22 total hours/week** to match W-2 (22 × 0.70 = 15.4 billable). **Maximizing net revenue**: **Strategy #1 - Raise rates**: Increase from $150 → $180 (+$30 gross) = net increases $30 × 0.49 = **+$14.70/hour** (49% flows to net because expenses mostly fixed).

Every $10 rate increase = $4.90 net increase. **Strategy #2 - Reduce overhead**: Switch from traditional office ($1,500/month) to shared/co-working space ($400/month) = save $1,100/month ÷ 80 sessions = **+$13.75/session** net.

Or go 100% telehealth = $0 rent = save **+$18.75/session**. **Strategy #3 - Increase productivity**: 60% → 75% productivity = same overhead spread over more sessions = overhead per session drops $36.87 → $29.50 (25% more sessions) = **+$7.37/session** net. **Strategy #4 - Tax optimization**: S-Corp election saves 5-8% self-employment tax on profit (CPA fee $1,500/year, saves $3,000-6,000/year on $60-100k profit) = **+$0.75-1.50/session** net.

Max retirement contributions (SEP-IRA $69k limit, reduces taxable income) = saves 30% tax on contributed amount. **Combined optimization**: $150 base → $180 rate (+$14.70), telehealth ($0 rent, +$18.75), 75% productivity (+$7.37), S-Corp (+$1.50) = **new net $116.32/hour** vs old $74.06 = **+$42.26/hour (+57% net income increase)** on same billable hours ✅.

**Weekly productivity dashboard (track these 7 metrics)**: **Metric #1 - Billable hours**: Count all revenue-generating clinical hours.

Target: 25-35 hours/week (solo practice), 28-40 hours/week (employed).

Track: Use EHR auto-count (SimplePractice Reports → Appointments), or manual spreadsheet (Date | Client | Duration | Billable Y/N). **Metric #2 - Total work hours**: All time spent on practice (clinical + documentation + admin + marketing + billing).

Target: 40-50 hours/week full-time.

Track: Time tracking app (Toggl, Harvest, RescueTime), or round estimate (clinical hours + 1.5-2× for non-clinical). **Metric #3 - Productivity rate**: (Billable ÷ Total) × 100.

Target: 60-65% employed, 70-75% private practice, 80%+ with optimization.

Track: Calculate weekly, monitor trend (improving/stable/declining). **Metric #4 - No-show rate**: (Cancelled/no-show appointments) ÷ (Scheduled appointments).

Target: <10% with good systems, <5% with strict policy.

Track: EHR cancellation report, count weekly cancellations ÷ total scheduled. **Metric #5 - Revenue per billable hour**: Total revenue ÷ billable hours.

Target: $100-200/hour depending on specialty/location.

Track: Monthly revenue (from EHR or accounting) ÷ monthly billable hours. **Metric #6 - Utilization rate**: (Filled appointment slots) ÷ (Available appointment slots) × 100.

Target: 80-90% (allowing some flexibility/breathing room), 95%+ = waitlist (great problem!).

Track: Weekly available slots (e.g., 40 slots) vs filled slots (e.g., 32 filled) = 80% utilization. **Metric #7 - Documentation time ratio**: Hours spent on documentation ÷ billable hours.

Target: 0.15-0.25 (15-25% of clinical time), equals 10-15 minutes per 60-minute session.

Track: Time tracking or estimate (30 clients × 10 min = 5 hours/week ÷ 30 billable hours = 16.7%). **Example weekly scorecard**: Monday-Friday work: 40 total hours.

Billable clinical: 28 hours (21 individual clients × 1 hour, 1 group × 90 min, 1 couple × 90 min, 1 intake × 90 min = 28 hours).

Documentation: 5 hours (10 min/client average).

Admin: 4 hours.

Marketing: 2 hours.

Supervision: 1 hour. **Calculations**: Productivity = 28 ÷ 40 = **70%** ✅.

No-shows = 3 cancelled ÷ 35 scheduled = **8.6%** ✅.

Revenue/hour = $3,920 week ÷ 28 hours = **$140/hour** ✅.

Utilization = 32 filled ÷ 40 slots = **80%** ✅.

Documentation ratio = 5 ÷ 28 = **17.9%** (10.7 min/session) ✅. **Tracking tools (2025 options)**: **SimplePractice/TherapyNotes built-in reports**: Appointments report (billable hours auto-calculated), revenue report, cancellation tracking, customizable date ranges, export to Excel for analysis. **Toggl Track** (time tracking): Free for solo users, mobile + desktop apps, tag time entries (clinical/admin/marketing), weekly reports show time allocation, integrates with calendar. **Google Sheets template** (DIY): Create columns: Date | Client | Session Type | Duration | Billable (Y/N) | Revenue | Notes.

Weekly summary: SUM billable hours, COUNT total hours, CALCULATE productivity %, total revenue.

Monthly dashboard with charts showing trends. **Practice management KPIs spreadsheet**: Track weekly over time (26-52 weeks), create line charts showing productivity trend (is it improving/declining?), annotate changes (new reminder system = no-shows dropped 20%), set quarterly goals (increase productivity 60% → 70% by Q2). **Benchmarking (compare yourself)**: **Personal baseline**: Track for 4-12 weeks to establish your typical numbers, then set improvement goals (+5-10% productivity). **Industry standards**: Compare to 60-75% benchmark, if <60% investigate why (scheduling? admin? too many no-shows?). **Group practice comparison**: If employed, ask manager for practice-wide average (are you above/below team?), discuss barriers if below (admin burden? difficult caseload? training needs?). **Common productivity problems revealed by tracking**: **Low productivity (40-50%)**: Excessive admin time (hire VA), high no-shows (implement stricter policy), too many gaps in schedule (optimize schedule blocks), slow documentation (use templates/voice-to-text). **High productivity (>85%)**: Burnout risk (not enough buffer time), skipping documentation (compliance risk), working unpaid hours (count all time honestly), need to hire support or raise rates to work less. **Declining productivity trend**: Client attrition (losing more than gaining, improve retention/marketing), increasing cancellations (reminder system failing?), personal burnout (consider reducing hours or taking break). **Goal-setting example using data**: Baseline: 60% productivity (24 billable/40 total), $90k/year revenue.

Goal: 70% productivity (28 billable/40 total), $105k/year revenue (+$15k).

Action plan: Reduce no-shows 15% → 8% (+2 hours/week), optimize schedule blocks (+3 hours/week), automate billing (+3 hours non-billable freed).

Timeline: 3 months to implement systems, track weekly, adjust as needed.

Result: Hit 70% by Month 4, sustain for 8 months = **$105k achieved** ✅.

**Top 10 time-drains ranked (2025 survey of 1,000+ therapists)**: **#1 - Clinical documentation (avg 6-8 hours/week)**: Progress notes, treatment plans, discharge summaries, intake paperwork. **Reduce to 3-4 hours**: Templates for common diagnoses (copy/paste, edit specifics only), voice-to-text dictation (speak notes, edit 2 min vs type 15 min), immediate documentation (right after session while fresh = 5 min vs end of week = 20 min), hire scribe/VA for $20/hour to type dictated notes (5 hours × $20 = $100, frees 5 hours = bill 4 more clients at $150 = profit $500). **#2 - Insurance verification and authorizations (avg 3-5 hours/week)**: Calling insurance to verify benefits, requesting session authorizations, appealing denials. **Reduce to 1 hour**: Automate with Headway/Alma (handle all insurance for 5-8% fee), batch verifications (dedicate 1 hour Friday for all new clients vs throughout week), hire billing specialist (VA $15-20/hour), use EHR auto-verify tools (SimplePractice insurance verification feature), go cash-pay only (accept no insurance, charge $120-180 out-of-pocket, clients submit own superbills). **#3 - Scheduling and rescheduling (avg 2-4 hours/week)**: Phone calls, emails, texts to schedule/reschedule appointments, calendar management. **Reduce to 0.5 hours**: Online self-scheduling (Calendly/Acuity/SimplePractice Client Portal lets clients book own appointments 24/7), auto-reminders (reduce inbound "what time is my appointment?" messages), strict rescheduling policy (clients must reschedule via portal, not by calling/texting), waitlist auto-fill (when cancel, auto-text waitlist, first response books). **#4 - Billing and collections (avg 2-3 hours/week)**: Submitting claims, following up on unpaid claims, chasing client copays, account reconciliation. **Reduce to 0.5 hours**: Auto-billing (EHR auto-submits claims weekly, auto-charges card on file for copays immediately after session), outsource to billing company ($150-400/month flat fee or 3-8% of collections, saves 2-3 hours/week), require payment at time of service (no invoicing/chasing needed, credit card required on file auto-charged), batch billing once/week (dedicate 1 hour Friday vs throughout week). **#5 - Professional development and supervision (avg 1-2 hours/week, required)**: Continuing education for license renewal, clinical supervision (giving or receiving), reading journals. **Cannot fully eliminate (licensure requirement)**: Choose efficient formats (online CE at 1.5× speed = 6 hours → 4 hours), batch supervision (bi-weekly 2-hour group vs weekly 1-hour individual), listen to therapy podcasts during commute (counts as CE in some states), attend conferences doubling as vacation (tax-deductible trip!). **#6 - Marketing and business development (avg 2-4 hours/week)**: Website updates, social media posts, networking events, Psychology Today profile, SEO, blogging. **Reduce to 1 hour OR outsource**: If waitlist exists (>3 months), **stop all marketing** (0 hours, clients find you via word-of-mouth), hire marketing VA ($200-500/month for social media management, blog posts, website updates), use templates/scheduling tools (Buffer/Hootsuite schedule 1 month of posts in 1 hour), focus only on highest-ROI channel (if Psychology Today brings 80% of clients, spend 1 hour/month there only). **#7 - Responding to emails and calls (avg 2-3 hours/week)**: Client questions between sessions, new client inquiries, insurance questions, coordination with other providers. **Reduce to 1 hour**: Set office hours for calls (M/W/F 12-1pm only, voicemail says "call back during office hours or leave message"), auto-responder email (FAQ document answering common questions, reduces 50% of emails), batch communication (check email 2× daily not constantly, respond all at once), 5-sentence max email rule (short answers encourage brevity), screening questions via online form (new clients fill out questionnaire, you call only qualified leads). **#8 - Administrative tasks (avg 1-2 hours/week)**: Filing, organizing paperwork, tax prep, bookkeeping, office management. **Reduce to 0.25 hours**: Go paperless (everything in EHR, zero filing), use accounting software (QuickBooks Self-Employed auto-categorizes expenses from bank feed, generates quarterly reports for CPA), hire VA for admin ($100-200/month, 5-10 hours), minimize office clutter (less stuff = less organizing). **#9 - Training and onboarding new software/tools (avg 3-5 hours one-time, 0.5 hours/week ongoing)**: Learning new EHR, setting up telehealth platform, mastering practice management tools. **Reduce**: Choose all-in-one platform (SimplePractice/TherapyNotes has scheduling + billing + notes + telehealth, learn once not 4 tools), use free trials (test before committing, avoid switching later), hire consultant for setup ($200-500 one-time saves 10 hours frustration), batch learning (dedicate 1 Saturday to master tool fully vs struggling weekly). **#10 - Coordination of care (avg 1-2 hours/week)**: Communicating with psychiatrists, primary care, schools, case managers, releasing records. **Minimize but necessary**: Standardized forms (HIPAA release template, care coordination template), batch (dedicate 30 min Tuesday/Thursday), bill for case management if possible (CPT 99366-99368 = care coordination billable 30-60 min at $75-150 to some insurers). **Time-saving workflow example (30 clients/week)**: Old way: 30 hours clinical, 8 hours notes, 5 hours insurance, 4 hours scheduling, 3 hours billing, 2 hours admin, 2 hours marketing = **54 total hours, 56% productivity**, exhausted.

New way: 30 hours clinical, 4 hours notes (templates), 1 hour insurance (automated), 0.5 hours scheduling (self-serve), 0.5 hours billing (auto), 1 hour admin (VA), 0 hours marketing (waitlist) = **37 total hours, 81% productivity**, same revenue, work 17 fewer hours/week = **reclaim 880 hours/year** (equivalent to 110 full workdays) ✅.

**Telehealth productivity advantages (5-15% higher)**: **Commute elimination**: In-person: Commute 20-60 min each way (0.5-2 hours/day unpaid), office prep time 10-15 min (arrive early, set up space, turn on lights/heat), total 1-3 hours/day overhead.

Telehealth: Log in 2 minutes before session, no commute, no setup, save 1-3 hours/day = **add 5-15 billable hours/week**.

Example: 40-hour work week in-person with 2-hour daily commute = 50 total hours (40 work + 10 commute).

Telehealth same 40 work hours = 40 total. **Scheduling flexibility**: Back-to-back sessions easier (no client overlap in waiting room, no "running late" anxiety), 10-minute gaps sufficient (vs 15-20 in-person for restroom/notes), can see 8 clients in 9 hours (8am-5pm with 1-hour lunch) vs 6-7 in-person (more gaps needed). **Result**: In-person 6 clients/day × 5 days = 30/week.

Telehealth 8 clients/day × 5 days = 40/week = **+33% productivity** in same work hours. **Reduced no-shows**: Telehealth no-show rate 8-12% vs in-person 15-25% (easier for clients to log in from home than drive to office, weather/traffic not barriers, last-minute availability higher).

Example: 40 scheduled sessions/week.

In-person 20% no-show = 32 actual sessions.

Telehealth 10% no-show = 36 actual sessions = **+4 sessions/week, +$500-800 revenue**. **Geographic reach**: Serve clients anywhere in your state (not limited to 20-mile radius of office), easier to fill schedule (larger client pool), attract niche clients statewide (specialize in OCD, eating disorders, etc.). **Technology efficiency**: Screen sharing for worksheets (no printing/organizing handouts), digital whiteboards for CBT thought records, auto-saved session recordings (with consent for supervision), easier consultation (quick Zoom call with psychiatrist vs phone tag). **Telehealth productivity challenges (-5 to -10% if not managed)**: **Tech issues**: 5-15 min/week lost to "I can't hear you, let me restart my WiFi" (build in 5-min buffer), invest in reliable platform (Doxy.me $35/month, SimplePractice Telehealth included, HIPAA-compliant better than Zoom), require clients test tech 10 min before first session (send test link 24 hours prior). **Home distractions**: Clients interrupted by kids/pets/roommates (less contained than office, reschedule/discount if major disruption), background noise in your space (barking dog, construction, household sounds), **solution**: Dedicated home office with soundproofing, white noise machine outside door, professional background (bookshelf, plants, not bed/kitchen). **Reduced rapport/engagement**: Some clients disconnect easier on video (multitasking during session, less eye contact, harder to read body language), therapist fatigue from staring at screen 6-8 hours (Zoom fatigue real!), **solution**: Limit telehealth to 6 hours/day max, take 10-15 min screen breaks between sessions (step outside, move body), in-person for clients needing higher engagement (severe cases, new intakes). **Boundary blurring**: Work-from-home makes it harder to "leave work" (home = office = stress), easier to overbook ("just one more client, I'm already at computer"), **solution**: Designated office hours (stop at 5pm, close door, don't check emails after), separate work/personal devices, track hours honestly (easy to work 50-60 without realizing). **Hybrid model (best of both worlds)**: **3 days telehealth (Mon/Wed/Fri)**: See 8 clients/day = 24 clients, save commute 6 hours, from home flexibility. **1 day in-person (Tuesday)**: See 6 clients needing in-person (EMDR, play therapy, severe cases), maintain office connection, break up screen time. **1 day admin/marketing (Thursday)**: Documentation, billing, meetings, consultation, no client sessions, from home or office. **Result**: 30 clients/week, 35 work hours (vs 45 all in-person), 86% productivity (30 billable ÷ 35 total), less burnout, higher satisfaction ✅. **Revenue comparison (2025 realistic)**: **In-person solo practice**: 25 clients/week (lower utilization 75% due to commute/no-shows), $150/session, $3,750/week × 48 weeks = **$180k gross**.

Minus office rent $18k, commute $3k (gas/wear) = $159k. 45 work hours/week average. **Telehealth solo practice**: 32 clients/week (90% utilization, less no-shows), $140/session (slightly lower rate, no office overhead), $4,480/week × 48 weeks = **$215k gross**.

Minus home office $2k (desk/tech/internet business portion) = $213k. 40 work hours/week. **Difference**: Telehealth earns **+$54k/year (+34%)** working 5 fewer hours/week ✅. **Client preference (2025 data)**: 60% prefer telehealth (convenience, no commute, lower cost), 25% prefer in-person (better connection, serious issues, no home privacy), 15% flexible (whichever is available sooner). **Best approach**: Offer both, let clients choose, slight premium for in-person to cover office cost ($150 in-person vs $130 telehealth), maintain mostly telehealth with 1-2 days in-person availability for those who need it.