NP Hiring

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Model a practice, then see how wrong it can be

Visits a week, what you collect per visit, weeks you work, overhead as a share of collections — the same four inputs our private practice guide builds its table from, except here you set them. Every preset loads the guide’s published figures, and anything the guide has no figure for starts at zero and says so.

An illustration, not a financial projection. It computes the assumptions you enter, before tax, and the sensitivity table exists to show how much a wrong assumption costs.

This is an illustration of arithmetic, not a financial projection. It multiplies the volume and per-visit collections you enter and subtracts the overhead you enter. It knows nothing about your payer contracts, your market, or your ramp — and the sensitivity table below exists to show how much the answer moves when those inputs are wrong.

Loads the midpoint of that scenario’s published volume and overhead bands. Selecting a scenario overwrites the fields below — then change whatever you like.

Guide band for full-time telehealth: 22–28.

Guide default: 46 — 52 less about six for holidays, vacation, and admin days.

What you COLLECT, not what you bill. Guide planning inputs: $175 insurance, $250 cash-pay. Replace with your contracted rates.

Guide band for full-time telehealth: 15–25%. Covers the costs that scale with volume.

Your assumption — we publish no figure for this. Starts at 0, which assumes every scheduled visit completes.

Your assumption — a lease, a specific EHR or billing contract. Starts at 0 because vendor pricing changes and we will not print a figure that expires.

Modelled net before tax

$161,000

From 1,150 completed visits and $201,250 of gross collections, less $40,250 of costs (20% of collections). Before self-employment tax and income tax.

Gross collections

$201,250

Overhead

− $40,250

Fixed costs

− $0

Net per completed visit

$140

Our private practice guide publishes full-time telehealth as $177K–$225K gross and $133K–$192K net, pairing its lowest volume with its highest overhead and vice versa. The figure above is a single point inside that method — the preset loads the midpoint of both bands.

How wrong can this be?

Each row moves one input and holds the rest. The column headings are moves relative to the value you entered, not percentage points — on your 20% overhead share, the +20% column is 24% of collections, not 40%. Each cell prints the value the model actually used underneath the net it produced. The swing column is what that single input is worth to your net across the range; the largest swing is the number to go and verify first.

Modelled net before tax when one input moves and the others hold.
Input-20%-10%+10%+20%Swing
Visits per weekyou entered 25 visits/wk$129Kat 20 visits/wk$145Kat 22.5 visits/wk$177Kat 27.5 visits/wk$193Kat 30 visits/wk$64K
Collected per visityou entered $175$129Kat $140$145Kat $158$177Kat $193$193Kat $210$64K
Overhead shareyou entered 20% of collections$169Kat 16% of collections$165Kat 18% of collections$157Kat 22% of collections$153Kat 24% of collections$16K

One more scheduled visit a week, all else equal, is worth $6,440 a year at these inputs. That is the number to hold your caseload plan against.

How this model is built

Every default on this page is either a figure our private practice guide already publishes, or a zero you replace yourself. There is no third kind.

What it assumes

  • The whole model is one line of arithmetic: scheduled visits per week × working weeks × the amount collected per completed visit, less overhead as a share of collections, less any fixed annual costs you add.
  • The presets are the 4 scenarios published in our private practice guide (part-time telehealth, full-time telehealth, full-time office, cash-pay panel). Selecting one loads the MIDPOINT of that scenario's volume and overhead bands; the guide's full band is shown next to the result so you can see what the midpoint left out.
  • Working weeks default to 46 — 52 less roughly six for holidays, vacation, and admin days, the same figure the guide uses.
  • Per-visit amounts are what a practice COLLECTS, not what it bills. The guide's planning inputs are $175 on an insurance panel and $250 cash-pay, and both are planning inputs rather than contracted rates — replace them with the rates you are actually offered.
  • Two inputs are yours alone and start at zero: the no-show and late-cancellation rate, and fixed annual costs such as a lease or a specific software or billing contract. We publish no figure for either, because vendor pricing changes and inventing one would put an expiring number on the page.
  • The sensitivity table moves one input at a time by up to ±20% and holds the rest, so the "swing" column reads as what that single assumption is worth to your net. Those percentages are relative moves on the value you entered, not percentage points — +20% on an overhead share of 20% of collections is 24%, not 40% — and every cell prints the input value it used so there is nothing to infer.
  • Net is before self-employment tax and income tax. A practice owner is a contractor for tax purposes, so a substantial further deduction applies to the figure shown.

What it does not include

  • Tax of any kind. Net here is pre-tax; self-employment tax alone takes a large bite, and the 1099 vs W-2 calculator models it properly.
  • Startup costs. Formation fees, credentialing, equipment, and a website are one-off costs this annual model does not carry — the guide covers them without printing figures that expire.
  • The ramp. A new practice does not open at full volume: payer credentialing has to complete before you can bill an insurer, and a panel fills gradually after that. We are not putting a number of days on either here — we have no defensible figure for how long your payers take, and it varies by payer and state. Ask each payer for its current processing time, then model your first year at a fraction of the steady-state volume you enter above.
  • Vendor pricing. No software, billing, or insurance prices are published here or in the guide. Get current quotes.
  • Any per-category overhead breakdown. Overhead is a single share of collections, because a per-line dollar default would be an invented figure — put your own line items into the fixed-costs field.
  • What a practice will actually earn. This computes your inputs. It has no knowledge of your payer mix, your market, or your referral base.

Sources

Questions about practice economics

How much can an NP private practice make?
It is a volume-times-collections calculation, which is exactly why a headline number is the wrong thing to look for. Enter your own visits per week, what you actually collect per visit, and your overhead share, and the tool works it through. Then read the sensitivity table: at typical inputs, being 10% out on either volume or reimbursement moves the answer by tens of thousands of dollars a year, which tells you the honest answer is a range whose width depends on how well you know your own numbers. For comparison, the national median annual wage for employed nurse practitioners is $129,210 (BLS OEWS, Nurse Practitioners (29-1171) — median annual wage, May 2024) — with malpractice, health coverage, and payroll taxes largely handled by an employer.
Why does this ask for collections instead of what I charge?
Because charges are not money. Contracted payer rates, patient responsibility that never arrives, denials, and write-offs all sit between a charge and a deposit, and a model built on charges overstates revenue by whatever that gap is. Track what lands in the account per completed visit and use that. If you are still negotiating contracts, use the rate you have been offered rather than your fee schedule.
What counts as overhead in this model?
Everything that scales with running the practice, expressed as one share of collections: billing, software, supplies, rent if you have it, staff, and the administrative cost of the panel. It is a single percentage rather than a list of line items on purpose — putting default dollar amounts against individual categories would mean publishing vendor prices we cannot stand behind. If you have real quotes for specific fixed costs, put them in the fixed annual costs field instead so they are subtracted as dollars rather than as a percentage.
Is this a financial projection I can show a lender?
No, and it should not be presented as one. It is an illustration of arithmetic that runs on assumptions you supply, and it deliberately excludes tax, startup costs, and the ramp period. A lender or an accountant will want a projection built on your actual contracted rates, a month-by-month ramp, and a full cost schedule. Use this to sanity-check whether the shape of the plan works before paying anyone to build that.
Should I model insurance or cash-pay?
Model both and compare. Insurance panels fill faster and reach more patients at a lower collected amount per visit, with real billing and credentialing overhead attached. Cash-pay collects more per visit with far less paperwork but fills slowly and depends on your local market. Switch the preset between the insurance scenarios and the cash-pay panel and watch what happens to net — then decide which risk you would rather carry.
Does this include what I pay myself?
The net figure IS what is available to you, before tax. It is not a salary line and there is no separate owner-compensation input, so do not subtract your own pay from it as if it were another cost. If you plan to employ someone else in the practice, their cost belongs in overhead or in fixed annual costs.

Before you commit

Private practice guide

Entity formation, credentialing, EHR, malpractice, and the model this tool runs.

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Practice authority guide

Whether an independent practice is available to you at all.

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Licensure checker

Your state’s authority classification and licensure steps.

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1099 vs W-2 calculator

The tax this net figure sits before, modelled properly.

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NP salary guide

What employed roles pay — the opportunity cost of going independent.

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Private practice roles

Work inside an existing practice before you start one.

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