ABA Therapy Practice Bookkeeping & Accounting
Fairlight CPA does the bookkeeping, payroll, and tax for ABA therapy practices — where revenue depends on authorizations, payers pay on their own timeline, and labor is the entire cost structure. We keep authorized-versus-delivered hours, billing lag, and per-session economics visible every month.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ CPA-led team
The numbers problems ABA therapy practices actually have
Authorization limits are your revenue ceiling
Delivered hours over the auth don't get paid; unused authorized hours are revenue you staffed for but never billed. Books that ignore authorizations can't explain either.
Payer lag stretches 30–90+ days
Medicaid programs and commercial payers each pay on their own clock. Cash in the bank says little about the month you just worked without a proper AR lane per payer.
RBT/BCBA payroll is the whole cost base
Labor is 60–80% of cost in ABA. Billable-versus-paid hours, cancellations, drive time, and supervision ratios decide margin — payroll and the P&L have to speak the same language.
Credentialing gaps freeze cash
A new hire seeing clients before payer credentialing completes means sessions delivered that can't yet be billed. That pipeline needs to be visible, not discovered.
Clawbacks arrive months later
Payer audits and recoupments hit long after the sessions. Reserving for them beats treating every remittance as final.
What Fairlight takes off your plate
The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how ABA therapy practices actually make and spend money.
- Revenue tracking by payer with billed, paid, and lag visible per program
- Session economics: delivered hours, billable rate realized, and labor cost per hour side by side
- Payroll for RBTs, BCBAs, and supervisors — including billable-hour and salaried mixes
- Monthly close by the 15th with AR aged by payer
- Business and personal tax prep, quarterly estimates, and CFO reporting for capacity and hiring decisions
The three numbers we keep in front of you
No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.
Realized rate per hour
what each payer actually pays per delivered hour, after adjustments
Days in AR by payer
how long each program really takes to pay — the cash-planning number
Labor cost per billable hour
RBT and BCBA cost against hours that actually billed, not hours scheduled
Revenue cycle & tax notes
Revenue & reconciliation
We reconcile clearinghouse remittances to deposits by payer, keep denied and resubmitted claims from vanishing into gross AR, and work alongside your billing team — they fight the claims, we make the financial picture reflect the fight.
Tax & entity
Growing ABA practices often cross state lines and payroll thresholds fast; entity structure, multi-state payroll registration, and owner compensation deserve a plan before the growth, not a cleanup after.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $800/mo. Every fee is quoted and fixed in writing before any work begins.
ABA Therapy accounting FAQs
Do you replace our billing company?
No — billing and credentialing stay with your RCM team. We reconcile what they collect to the bank, keep AR honest by payer, and make sure the P&L reflects delivered care, not just posted cash.
Can you show whether a new RBT cohort pays for itself?
Yes — that's the labor-cost-per-billable-hour view: comp, supervision load, and ramp time against the hours that actually bill. It's the number to check before every hiring wave.
We're expanding to a second state — what changes?
Payroll registration, unemployment accounts, and possibly entity foreign-qualification in the new state; payer enrollment timelines matter too. We map the obligations before the first hire so nothing accrues penalties.
What does it cost?
Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $800/month. Exact fee fixed in writing after a short call.
Related healthcare specialties
Get the financial side handled
A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for ABA therapy practices.
The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.