WP166 | What Should I Pay Myself as a Practice Owner with Barry Roach

Hi friends! Whitney here — and today’s Wise Practice episode is one every single practice owner needs in their back pocket. Whether you’re brand-new to private practice or scaling into a thriving group, the same question always surfaces: “What should I actually pay myself?”

It sounds simple… until taxes, entity types, self-employment rules, “reasonable salary” requirements, and quarterly payments make your head spin. That’s why I brought on someone who makes money talk feel human — Barry Roach Jr., enrolled agent and owner of Core Accounting & Consulting Group.

Barry has spent years helping therapists understand their numbers, strengthen their financial foundation, and navigate tax decisions with confidence. And in this episode, he breaks down:

✨ When (and when NOT) to elect S-Corp status

✨ What “reasonable salary” really means — no guesswork

✨ The mistake new practice owners make when paying themselves

✨ How to avoid a painful April tax bill

✨ The simple formula for deciding what to take home today

If you’ve ever wondered whether you’re paying yourself too little, too much, or totally wrong… this episode will save you stress, money, and confusion.

Trust me — you’re going to walk away feeling empowered and clear on your next steps.

You Can’t Always “Pay Yourself a Salary”

Early in private practice, most owners operate as sole proprietors or single-member LLCs. In both of these structures, the business is taxed the same way — through your personal tax return.

In this stage:

  • You cannot pay yourself a salary

  • You pay taxes on your net profit, not on what you withdraw

  • Any money you take from the business is considered an owner distribution

This means you owe taxes on your profit, whether or not you actually move that money into your personal account. This is often where new practice owners feel confused or caught off guard.

Understanding Self-Employment Tax

In addition to regular income tax, practice owners pay self-employment tax, which covers Social Security and Medicare. This tax is 15.3% and is paid on top of income tax.

When federal, state, and self-employment taxes are combined, it’s common for practice owners to owe a significant portion of their profit in taxes. This is why planning ahead — and setting money aside consistently — is so important.

A conservative and commonly used approach is to save around 40–45% of your profit for taxes. This isn’t exact for everyone, but it helps prevent under-saving and year-end stress.

When an S-Corporation Can Make Sense

As your practice becomes more profitable, you may have the option to elect S-Corporation status. This is not a new business entity, but a tax election that allows owners to pay themselves differently.

An S-Corp can be beneficial when your practice is generating consistent profit, typically somewhere in the $60,000–$80,000 range or higher. Before that point, the additional costs often outweigh the benefits.

With an S-Corp:

  • You pay yourself a reasonable salary through payroll

  • Remaining profit can be taken as distributions

  • Distributions are not subject to self-employment tax

This structure can result in meaningful tax savings, but only when implemented at the right time.

Why “Too Early” Can Cost You Money

Electing S-Corp status too soon can actually increase expenses rather than reduce them. Payroll services, additional tax filings, and administrative costs can quickly cancel out any potential tax savings.

This is why S-Corp elections should always be evaluated based on profit, not revenue — and ideally with guidance from a tax professional.

How to Determine a Reasonable Salary

One of the most misunderstood parts of S-Corporations is the idea of a reasonable salary. The IRS doesn’t provide a single formula, which leads many owners to guess — or rely on oversimplified rules.

A more thoughtful approach is to look at the many hats you wear as a practice owner.

Most owners spend time in multiple roles, such as:

  • Providing therapy services

  • Administrative work

  • Marketing and outreach

  • Bookkeeping or payroll

  • Leadership and management

Each role has a different market value. If you were hiring others to do this work, you wouldn’t pay the same rate for every task. A reasonable salary reflects a blended rate based on how your time is actually spent.

This approach is not only more defensible, but often results in lower payroll costs and better tax outcomes.

Quarterly Taxes and Safe Harbor Rules

Unlike W-2 employees, self-employed practice owners don’t have taxes withheld automatically. To address this, the IRS requires quarterly estimated tax payments.

The goal is to pay taxes throughout the year rather than all at once. If you don’t pay enough, you may face penalties.

One way many owners manage this is by using safe harbor rules, which allow you to avoid penalties if you pay:

  • 90% of the current year’s tax, or

  • 100% of the prior year’s tax liability

Understanding these thresholds helps owners plan with more confidence and avoid surprises.

Partnerships Are Different

If your practice has more than one owner and has not elected S-Corp status, the business is typically taxed as a partnership.

In this structure:

  • Owners still cannot be paid a salary

  • Compensation is handled through guaranteed payments

  • Taxes are paid based on profit allocation

Partnership taxation adds another layer of complexity, making professional guidance especially important.

Paying Yourself Is a Leadership Decision

How you pay yourself isn’t just a tax decision — it’s a leadership one. Paying yourself appropriately supports sustainability, reduces burnout, and allows you to lead your practice with clarity instead of anxiety.

When owners understand their numbers, they can make decisions rooted in wisdom rather than fear — and that impacts everything from hiring to growth to long-term stability.

Barry Roach’s Resources

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WP167 | Staying the Course (Part 1 of 4): Faithful Leadership When the Numbers Feel Unsteady

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WP165 | End of Year Insurance Billing Procedures with Davia Ward, CMRS, CBCO