The Math is Mathing (But You’re Doing it Wrong): Income vs. Revenue

Let’s talk about money. Specifically, let’s talk about how we talk about it.

In the therapy world, we love to share “wins.” You’ll see it in Facebook groups or hear it at consultations: “I’m a six-figure therapist!” or “My supervisor is stealing 50% of my money!” The problem is that without context, these numbers are meaningless. When we conflate revenue with income, we aren’t just being imprecise…we’re setting ourselves (and our pre-licensed colleagues) up for a massive expectations hangover.

The Great Misunderstanding: Revenue vs. Income

I have recently been asking other therapists the question, “What assumptions do you make when you hear other therapists talk about how much they make?” to see how much confusion is actually out there. Granted, this is an informal survey with no real methodology behind it, but the results seem to be all over the place. In general, about half of the people who responded to my question seemed to assume when someone says “I’m a six-figure therapist!” that they are talking about gross revenues and the other half seem to think that it is take home salary.

The stage of career and type of setting someone works in also seemed to impact the way that the question was answered. Prelicensed therapists and those who were salaried employees tended to view the answer in terms of take-home pay, while private practice therapists tended to view the answer as gross revenue.

The biggest hurdle in our professional discourse is a lack of financial literacy. Breaking down the three tiers of money flow that every therapist from associates and trainees to the seasoned group practice owners need to understand.

1. Gross Revenue: This is the total amount of money that hits the bank account before a single bill is paid. If your rate is $150 and you see 20 clients, your revenue is $3,000. This is not your take home money. This is the business’s money before expenses get paid.
2. Net Income (The Paycheck): This is what you actually get after the split or after the practice pays its overhead and discretionary spending.
3. Take-Home Pay (The Real Money): This is what’s left after the IRS takes their cut, you pay for your own health insurance, and you fund your own retirement.

“My Supervisor is Taking Half My Money”

I hear this from associates constantly. “I bring in $120 a session, but I only see $60 of it. My supervisor is taking half of my money!”

Let’s get real: Unless your supervisor is running a practice out of a cardboard box with no Malpractice insurance, no EHR, no rent, and no marketing budget, they are not “taking” $60. We covered this in our podcast episode “How Therapists Get Paid”

When an associate looks at a 50/50 split, they often fail to account for the Cost of Doing Business. That $60 covers:

• The rent for the office you’re sitting in.
• The HIPAA-compliant software you use to take notes.
• The billing specialist who fights with insurance so you don’t have to.
• The employer-side taxes (if you’re a W-2).
• And yes, the supervision time.

When we frame it as “taking my money,” we ignore the systemic costs of running a clinically sound practice. It creates a culture of resentment instead of a culture of business transparency.

W-2 vs. 1099: Not All Splits Are Created Equal

This is where the “Six-Figure Therapist” myth usually falls apart.

A therapist making $80k on a W-2 is often “wealthier” and more stable than a 1099 contractor “making” $100k who hasn’t realized they owe $25k in back taxes and $600 a month for a Silver PPO plan.

Why This Matters for the Therapists

If we want to stop the cycle of burnout, we have to stop lying to ourselves and others about the numbers.

When you hear a colleague brag about their income, ask them: “Is that before or after you set aside 30% for the IRS?” When you’re an associate feeling exploited, ask for a “Profit and Loss” transparency talk so you can get a sense of where that 50% split actually goes.

We are clinicians, yes. But we are also economic actors in a complex healthcare system. If we can’t talk about our own money with clarity, how can we expect our up and coming colleagues to be able to enter into our field successfully?