The honest checklist
Every telehealth practice with minors needs the same foundation:
- License in every state where a child will be during sessions. Compacts help counselors and psychologists; social workers and MFTs still need each state.
- Business entity and tax setup. An LLC or PLLC where your state allows it, an EIN, a business bank account. A CPA who knows clinicians is worth the fee.
- NPI type 1, and a type 2 if you bill as an entity.
- Malpractice insurance with telehealth and minors explicitly covered.
- A HIPAA-compliant telehealth platform and EHR with a signed business associate agreement.
- Consent forms for minors: who can consent in your state (one parent, both, the teen at a certain age), what a divorced parent needs, what the teen is told about confidentiality, telehealth-specific consent, and emergency contact and location for every session.
- A safety protocol for a child in crisis on video: local emergency numbers for the child's location, a parent reachable in the house.
- Insurance credentialing if you take insurance, and it takes 30 to 120 days per payer. See credentialing and CAQH.
- Documentation habits from day one. See notes and treatment plans.
Solo, group, or platform
People frame this as independence versus employment. The better questions are practical: who brings the families, who carries the payer risk (you get paid when the claim pays, or you get paid when the session happens), who does credentialing and billing, and who owns the schedule.
Solo private practice | Group practice | A platform that brings families | |
|---|---|---|---|
Who fills the calendar | You | The group, partly | The platform |
Payer risk | You | Usually the group | The platform, on Emora |
Credentialing and billing | You, or a biller you pay | The group | The platform |
Schedule and caseload size | Yours | Negotiated | Yours, within demand |
What you own | Everything, including the empty slots | A share | Your practice, your license, your clients |
Many clinicians run more than one of these at once: a small self-pay practice plus a platform caseload, or a day role plus evenings on Emora.
The after-school math
Children are in school until three. Parents work until five or six. The sessions families can actually attend fall between three and nine on weekdays and on weekend mornings. A practice that offers those hours has more demand than it can serve; a practice that offers ten to two competes with every other therapist for the same few slots. Ten to fifteen sessions a week in that window, held every month, is a full caseload for most clinicians who also have a day role.
The three ways a caseload fills
Your own marketing and directories. A website, a Psychology Today profile, Google Business, social posts. It works, slowly, and it never stops needing attention. Expect months before the calendar is steady, and expect to keep doing it.
Referral relationships. Pediatricians, school counselors, and other therapists refer children when they know you and trust you with families. This is the best source and the slowest to build; it lives on returned calls and clear reports back.
A platform that brings families. Emora markets to families, runs a provider directory, takes referrals from schools and physicians, and refers among its own clinicians. Your calendar fills from that demand, in the after-school hours, without you doing marketing. The trade is that the families are Emora's patients as much as yours: the payer contract, the record, and the standards of care are shared.
Keeping a day job while you build
Most clinicians on Emora have another role: an agency, a school, a hospital, or their own daytime practice. Evenings and weekends on Emora fit next to that. Watch for non-compete clauses in an agency contract and for the hours you can sustain.
When to bring your own clients
If you already have families who want to see you and take insurance you are credentialed with under Emora, you can bring them; clients you bring are paid at a higher rate than clients Emora brings, because you did the finding. Ask before you move anyone.
How this works on Emora
On Emora the checklist shrinks. We provide the EHR (the Emora Care Platform), the credentialing with every payer we bill, the billing, the consent forms built for minors and telehealth, the safety protocol, and the families, booked into your after-school hours. What stays yours: your license, your malpractice, your clinical judgment, your hours, and your practice. You are paid per completed session, twice a month, whether or not the payer has paid. Bring your own clients and they are paid at a higher rate.
Questions clinicians ask
- Do I need an LLC?
- Not to practice, but most CPAs recommend one (or a PLLC where required) for liability and taxes. Emora clinicians receive a 1099 either way.
- Which telehealth consent do I need for a 14-year-old?
- It depends on the state: usually a parent's consent plus the teen's assent, with state rules on what a teen can consent to alone. Emora's consent flow handles the state rules.
- How long until a new practice fills?
- Solo, months to a year. On Emora, most clinicians see their first families within a few weeks of accepting, as payers clear.
- Can I run Emora next to my own practice?
- Yes. Many clinicians do.
- What if I already have clients?
- Bring them, if they take insurance we bill and you are credentialed. Clients you bring are paid at a higher rate.
Sources
This is general information for licensed clinicians, not legal or billing advice. Your board and your payer contracts control.