How Much Does It Cost to Start a Private NP Practice?
Author: Dr. Jason Crumpler, MD, MBA
It doesn’t cost a fortune. But it isn’t cheap.
If you want to hang your shingle, there are fixed costs you can’t avoid. Legal. Malpractice. Systems. A place to see people, even if that’s telehealth. You can build lean, or you can build big. The core structure stays the same.
On the business side. You’ll need to form a legal entity—an LLC, usually. That comes with state filing fees, a registered agent, sometimes a lawyer. Some states make it simple. Some make it tedious. Budget for both possibilities. EIN comes next. That part is free. Setting up a business bank account, not quite.
Next is malpractice. Carriers price differently depending on your scope, location, and whether you're claims-made or occurrence-based. If you're in urgent care, expect more than family med. If you're in behavioral health, expect less. Paying monthly doesn't save money, but it spreads the pain.
Then there’s your EHR. Some are bloated. Others are bare bones. Most charge per user, per month. The more features, the more cost. Make sure it does what you need—and nothing more. No sense paying for optical module software if you're doing primary care.
And Administration. Don’t forget scheduling, payment processing, and secure messaging. Most EHRs bundle that now. If they don’t, you’ll be patching it together with plug-ins and workarounds. That eats time and money.
You’ll also need a space—even if it’s virtual. Physical clinics need leases, CAM charges, insurance, furniture, signage, biohazard disposal. Virtual practices still need HIPAA-compliant video tools and a mailing address for your corporate documents.
And yeah, you’re going to need to get credentialed. That’s a cost too. Payers will ask for your NPI, your CAQH, your business license, sometimes your blood type. You can try to do it yourself, but trust me, you won’t enjoy it.
Phones matter. So does branding. So does making sure your lab orders and imaging referrals actually go somewhere. You’ll need a way to store records, a way to send prescriptions, a way to get paid.
The supervision cost—if you're in a state that requires it—varies. Market rate floats by region, by specialty, and by how much involvement the doc actually has. Some charge a flat fee. Some want a slice of revenue. Don’t pick based on price alone. You’ll regret it.
Some NPs get up and running for less than what it costs to buy a used car. Others spend more than a year’s salary building a flagship clinic with wraparound services. One isn’t better than the other. They just have different goals.
If you know what you want to build, we can help you price it right. If you don’t, we can help you figure that out too.
Want to know what you’re getting into? Setup a time with our team to go over your staretgy and get in the ballpark.
— Jason