Private Practice Tips for School-Based SLPs An SLP shares the questions—and answers—she asked herself when launching a part-time private practice. School Matters
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School Matters  |   January 01, 2018
Private Practice Tips for School-Based SLPs
Author Notes
  • Aruna Hari Prasad, MA, CCC-SLP, is ASHA associate director of school services. ahariprasad@asha.org
    Aruna Hari Prasad, MA, CCC-SLP, is ASHA associate director of school services. ahariprasad@asha.org×
Article Information
School-Based Settings / Practice Management / Professional Issues & Training / School Matters
School Matters   |   January 01, 2018
Private Practice Tips for School-Based SLPs
The ASHA Leader, January 2018, Vol. 23, 38-39. doi:10.1044/leader.SCM.23012018.38
The ASHA Leader, January 2018, Vol. 23, 38-39. doi:10.1044/leader.SCM.23012018.38
My private practice story started nine years ago. I was working as a speech-language pathologist in a nonpublic special education school for students with language-learning disabilities and co-teaching a summer reading program at a different private school. After the summer reading program ended one year, a parent of one of my students asked if I could continue working with her daughter.
The first questions I asked myself involved the ethics of me treating her privately.
Should I worry about ethical issues? Was this a conflict of interest?
The answer to both of these questions was no. I was abiding by the principles and rules—there was not a gray area in sight—in ASHA’s Code of Ethics. Treating this student also fell within ASHA’s scope of practice in speech-language pathology. I wasn’t seeing a student from my primary place of employment, and I would provide services only in areas in which I had training and expertise.
However, if I were considering seeing a student from my school, I would have reviewed my employment contract, informed my administrators, and made sure families knew they could work with other SLPs, in addition to me.
If I worked in a public school, I could’ve referenced “Issues in Ethics: Obtaining Clients from Primary Place of Employment,” which safeguards the interests of the student or client by ensuring they are informed of all options for speech-language services, and are voluntarily choosing to work with a specific SLP.
I started my practice with this one student. I got liability insurance and created appropriate documentation, including a notice of patient privacy, consent for and authorization of services, and release of information from the family. I continued working full time in schools. I added a few more clients from the same private school and scheduled their sessions after a full workday.
After a few years of this schedule—and the birth of two of my children—I decided to leave my school and pursue a part-time private practice. Shortly after I made this choice, a learning specialist from a private school where I had worked years ago contacted me. She wanted to refer a fifth-grade student with language-learning difficulties. At this crossroads, I asked more questions about how to run my practice while maintaining relationships with schools where I had worked.
Although I ultimately left my full-time job in the schools for a part-time position at ASHA, I continue running my part-time private practice; any school-based SLP wanting to practice privately on the side can benefit from the guidelines I share here.
The school where I previously worked gave out my name as one among many SLPs, and contacted me if they felt a student would benefit from my expertise. The learning specialist invited me to see students on the premises, but the school made no legal or financial connection with me.

I defined my rates, policies and procedures by consulting with colleagues in private practice and checking outpatient-clinic fee scales.

What business decisions do I need to make?
I alone decided how my practice operated after making several decisions and taking several steps.
  • Was my practice going to be a sole proprietorship or a limited liability company (LLC)? The difference between the two relates to liability protection and taxation. A sole proprietor remains personally liable for debts incurred while operating the business. An LLC designation provides some limited liability protection and offers more operational flexibility. In an LLC, however, owners—called members—can’t pay themselves wages. Instead they just withdraw money from the LLC account, which is considered taxable income but isn’t subject to salary withholdings like Social Security. I was operating on a small scale, so I opted for sole proprietorship.

  • Next, I secured an employer identification number (EIN) through the Internal Revenue Service—a straightforward process requiring basic personal and business information—and I received my EIN within minutes. Your EIN is used on all insurance claim forms.

  • I also decided to run my business as fee-for-service. I don’t accept insurance; however, I give families invoices so they can secure reimbursement. I use Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) codes and Current Procedural Terminology codes (CPT, ® American Medical Association) for speech-language services. This decision made my billing practices simpler. (If you decide to accept insurance, you will need a National Provider Identifier number).

  • Finally, I created business cards and custom stationery used for progress updates. I also launched a practice website. I defined my rates, policies and procedures by consulting with colleagues in private practice and checking outpatient-clinic fee scales. I decided not to have families sign service contracts, so either party could terminate services at will with sufficient notice.

I consulted with professionals, including a lawyer and the Internal Revenue Service, to understand and ensure legal and tax compliance. I continued with this part-time, simple model. Then—about four years ago—I added speech-language screenings at a preschool, so I invested in screening tools and increased my intervention material inventory. As I grew my private practice, new questions arose.

Was my practice going to be a sole proprietorship or a limited liability company? The difference between the two relates to liability protection and taxation.

Do I need to alter components of my practice as I grow?
I now employ two subcontractors, who conduct preschool screenings and see some clients. Neither person works with me more than a few hours a week. This means I don’t have to deduct taxes or provide benefits. Again, this model works for the size and range of my practice.
As with any professional venture, use all available resources, tools and guidance to ensure compliance with federal, state and local laws, as well as with school policies and procedures.
I found starting and running a small private practice rewarding: It allows you to answer to yourself and your clients directly. And you see how much families, school professionals and members of the community recognize and value your professional skills. I also work hard. Just like when I was a school-based SLP, I plan for my sessions and correspond with parents or school staff on evenings and weekends. Additionally, I complete invoices for families, and submit taxes.
I continue to grow and learn as a private practitioner, but enjoy the ways our profession allows me to challenge myself, develop new skills, and expand on my clinical and professional training.
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January 2018
Volume 23, Issue 1