Bottom line
This model is built around a $350/month subscription, a sustainable steady-state panel of approximately 104 patients, a clinical schedule designed to end by 2 PM daily, and a path to your $20K income target within the first year of operation. If this overview feels like the right direction, the next two steps are straightforward: review the current employment agreement with someone qualified, and settle on the practice name.
01 · How It Works
Patient onboarding pathways and pricing structures
Every patient begins with a one-time intake evaluation, routing into one of two pathways depending on clinical readiness.
Path 1
Ready to begin
direct
The patient is ready to begin ongoing care. Following the intake evaluation fee, the evaluation takes place and the monthly subscription begins immediately to cover the full scope of services.
INTAKE FEE
$350 one time
THEN
$350/mo subscription
Path 2
Wants to explore first
trial
Designed for patients evaluating fit before committing to a subscription. The patient pays the intake fee, completes one follow-up visit at the standard rate, and then decides. If they subscribe, the follow-up fee applies as a credit, reducing the first month to $175.
INTAKE
$350
FOLLOW-UP
$175
FIRST MONTH
$175 after credit
THEN
$350/mo
What the subscription covers
This is not a medication-only practice. The subscription includes a comprehensive set of services provided by a single clinician who knows your history, your family, and your goals.
✓
Psychotherapy and talk therapy
✓
Psychiatric medication evaluation and management
✓
Structured psychoeducation
✓
Care coordination and referral navigation
✓
Crisis planning and stabilization support within the boundaries of the practice
✓
Secure non-urgent messaging between visits
Both paths cost your patient the same total through the end of their first subscription month, but Path 2 includes a built-in decision point. If a Path 2 patient chooses not to continue after the follow-up visit, they have paid $525 for two clinical sessions. If they discontinue, they have still received a complete intake, a follow-up visit, and appropriate next-step guidance before leaving the practice.
02 · Your Day
What does this practice actually look like?
The clinical schedule operates Monday through Friday from 9 AM to 2 PM, capping the clinical day at five hours. Below is a representative day. While most days begin with a new patient intake, the actual weekly schedule distributes four intakes across the week rather than scheduling one every single day.
9:00
New patient intake evaluation
60 min
10:00
Established patient follow-up
30 min
10:30
Established patient follow-up
30 min
11:00
Established patient follow-up
30 min
11:30
Established patient follow-up
30 min
12:00
Established patient follow-up
30 min
12:30
Established patient follow-up
30 min
1:00
Established patient follow-up
30 min
1:30
Held for urgent or overflow needs
buffer
Follow-ups are 30 minutes; intakes are 60 minutes. The 1:30 PM buffer slot is held daily. If unneeded, the clinical day ends early. In cases of urgent patient needs, this protected slot prevents schedule disruption across the rest of the day.
03 · What You'll Earn
The four numbers that matter
The year-one revenue model is built on 4 new patient intakes per week and checked against regional pricing research.
Active patients
~104
Sustainable steady-state panel at 4 new intakes per week and an average care duration of 6 months.
Monthly subscription
$350
Working price based on your own market research and validated against your current practice costs. Covers a full clinical service suite, not medication management alone.
Take-home at steady state
~$27K
After overhead and taxes at full panel, including intake fees. Your $20K goal is reached around month 9 of operation. Figures include all revenue streams.
New patients per month
~17
At 4 intakes per week, approximately 17 new patients join each month; both to grow the panel during ramp-up and to replace natural turnover at steady state.
How you get there · month by month
The practice does not reach full income on day one. Here is the honest picture of what the ramp looks like based on 4 new patients per week from launch.
| Milestone |
Active Patients |
Est. Take-Home |
What this means |
| Month 2 |
~31 |
~$9,600 |
Early ramp. Subscription revenue is small but intake fees from 17 new patients joining this month contribute meaningfully. See the formula breakdown below. |
| Month 3 |
~43 |
~$12,400 |
Your $12K income floor is crossed. The practice is now self-sustaining above your minimum threshold. |
| Month 6 |
~68 |
~$18,300 |
Approaching the income target. The model depends on referral relationships producing consistent new patients by this point. |
| Month 9 |
~83 |
~$21,900 |
Your $20K income target is exceeded. Nine months from launch. |
| Mature steady state |
~104 |
~$27,400 |
Once the panel has fully stabilized and startup costs are fully amortized, take-home is well above target. |
All take-home figures use the Month 2 formula: subscription revenue plus intake fees ($350 per new patient), minus Stripe fees, $1,900/month overhead, year-one startup amortization ($714/month), and a 30% combined tax estimate. Path 2 follow-up fees and first-month credits net to zero for converting patients. The model assumes four weekly intake slots yield approximately 17 subscription patients per month. Intake fees remain a consistent revenue stream, generating roughly $5,950/month across both ramp and steady state. "Active patients" represents patients billed for a subscription during that specific month. Panel growth calculations assume a standard 6-month average care duration with a 16.6% monthly turnover rate. Year-one figures include launch cost amortization ($8,564 total over 12 months); mature steady-state figures exclude this expense.
Where these numbers actually come from
Every monthly take-home figure is built the same way. The section below walks through the formula in full; you can read it now or refer back to it when specific numbers come up in conversation.
The formula · every month
1
Active patients × $350
= Monthly subscription revenue
2
New patients this month × $350
= Intake evaluation fees
3
① + ②
= Gross revenue
Note: Path 2 follow-up fees ($175) and first-month subscription credits ($175) offset each other for converting patients and are netted to zero. Non-converting Path 2 patients contribute a small amount of follow-up revenue without subscribing; this marginal variance is excluded for simplicity.
−
2.9% of gross + $0.30 per successful transaction
= Stripe processing fees (assumes standard domestic card transactions)
−
$1,900/month
= Monthly overhead (EHR, messaging, insurance, bookkeeping)
−
$714/month (year one only)
= Launch costs amortized
$8,564 total across these one-time items, spread evenly over 12 months:
DEA registrations × 3 states ($2,664) · Foreign entity filings in MD + DC ($320) · Registered agents year one ($400) · Attorney engagement (~$2,000) · CPA initial engagement (~$500) · HIPAA compliance setup and SRA (~$800) · Minimum launch hardware (~$700) · Initial directory listings and launch marketing (~$500) · Website, domain, and setup (~$200) · Miscellaneous launch costs (~$480)
=
Net income before tax
Taxes are calculated strictly on net business income rather than gross revenue. Overhead, processing fees, and launch costs are legitimate business deductions that reduce your taxable income liability.
−
30% of net income before tax
= Federal, state, and self-employment taxes combined
Month 2 · worked example
Month 2 starts in October 2026. You have been seeing patients for two months. Here is exactly where the numbers come from.
October 2026 · Month 2 · Approx. 31 active patients
Revenue coming in
1 Subscriptions; 31 patients × $350
$10,850
2 Intake fees; 17 new patients × $350
$5,950
3 Gross revenue
$16,800
What comes out before you see it
Stripe processing fees (~3%)
−$505
Monthly overhead
−$1,900
Launch costs, year-one amortization
−$714
Net income before tax
$13,681
Taxes; 30% of $13,681
−$4,104
Month 2 take-home
~$9,600
Month 2 income reflects early-stage panel growth with 31 active subscriptions. Intake fees from the 17 new monthly patients provide critical short-term cash flow, though subscription revenue remains the primary economic driver. As the panel expands, subscription recurring revenue becomes overwhelmingly dominant.
The $350 price point came from your conversations with other providers in the area, then held up when checked against regional market research.
If the price were $300
The practice remains viable at $300, but thinner margins reduce the safety cushion for slow referral months, lower conversion rates, or overhead spikes. Pricing at $300 also undervalues comprehensive care relative to the Northern Virginia market.
At $350 · the right balance
The model validates this target. At $350, the practice absorbs up to 10 reduced-rate slots while exceeding your $20K income goal. More importantly, the price reflects a comprehensive clinical suite (psychotherapy, med management, care coordination, and crisis planning) rather than a medication-only service, offering strong value for the level of care provided.
If the price were $400
While a higher fee requires fewer total patients, $350 is an intentional choice aligned with your core focus on accessibility for postpartum women. A $350 fee preserves strong practice economics while remaining accessible to a broader regional demographic.
04 · Pro Bono & Accessibility Mapping
Pro bono and reduced-rate accessibility math
Structuring an accessible practice requires concrete financial margins, not speculative planning.
Sliding Scale Viability
At a steady-state panel of 104 patients, maintaining 10 slots at a reduced rate of $150/month reduces gross monthly revenue by $2,000. Post-tax, this represents a take-home reduction of approximately $1,400.
Estimated monthly take-home shifts from ~$27,400 to ~$26,000. The reduced-rate framework is financially viable and keeps the income target aligned with the values behind the practice.
This functions as a discretionary, case-by-case private accommodation rather than a public sliding scale. You retain absolute control over qualification criteria, rates, and slot availability.
Maintaining ten reduced-rate slots at full panel secures your baseline $20K target while protecting clear boundaries for mission-driven care.
05 · Acuity Options
Acuity scenarios and clinical capacity
While patient mix is variable, you can shape the profile of your panel through targeted referral networks and intake criteria. These three profiles yield identical revenue; variations only impact your total monthly clinical hours.
Scenario A
High Acuity (Launch Phase)
New practices often attract complex cases initially. Patients who have struggled in traditional systems frequently seek out new specialists, resulting in a more intensive initial clinical load.
30%High acuity
40%Mid acuity
30%Maintenance
~78 hrsMonthly hours
Schedule near capacity | Full but manageable clinical days
Scenario B · Your Data
Baseline Profile (Actual 8-Week Scheduling Data)
The panel trends toward maintenance care with a sustainable high-acuity baseline, aligning with an 80% established, 20% new patient split. This matches your actual data, showing that the practice runs roughly 80% established and 20% new at any given time.
12.5%High acuity
17.5%Mid acuity
70%Maintenance
~34 hrsMonthly hours
Sustainable schedule | Significant breathing room
Scenario C
Mature Panel Profile
Long-term stabilization pattern. As the practice matures, established patients transition to lower-frequency maintenance monitoring, creating a lighter, highly predictable schedule.
5%High acuity
15%Mid acuity
80%Maintenance
~26 hrsMonthly hours
Light schedule | Room for additional focus areas
Monthly acuity-hour estimates represent established-patient follow-up demand and exclude the four weekly intake slots.
Because the subscription model decouples revenue from hourly utilization, shifting acuity levels only changes your total monthly clinical hours, not your revenue output.
06 · Prerequisites
Prerequisite launch decisions
01
Review existing employment covenants with an attorney
If this overview feels like the right direction, this is the first boundary to clarify. While working through the launch planning, I came across a Virginia law change taking effect July 1, 2026 that made me think about your current employment agreement. The law change may or may not affect your situation directly, but it raises the practical question: does the agreement you already signed include any non-compete, non-solicitation, confidentiality, repayment, patient-notification, or outside-work restrictions that could affect public launch steps, referral outreach, or patient transition planning?
02
Finalize corporate entity name
Settle on a practice name to initiate legal entity formation. This step can run completely parallel to your attorney consultation.
07 · Legal Context
Why attorney review still matters
Restrictive Covenant Analysis
Why the current agreement still matters
Virginia House Bill 627 and Senate Bill 128 generally restrict non-compete agreements for covered licensed healthcare professionals. However, those statutory changes apply prospectively to agreements entered into on or after July 1, 2026. Restrictive covenants signed before that date remain subject to previous legal frameworks.
Related provisions, including non-solicitation, confidentiality, repayment, and patient-notification language, may still matter under either legal framework. A Virginia healthcare attorney should review the current agreement before public marketing, entity setup, referral outreach, or patient transition planning begins.
This overview does not constitute formal legal advice. The underlying source materials are provided below for independent validation.