Running a therapy practice in the U.S. means more than just providing great care—it also means handling payments securely and professionally. Today, most clients expect to pay with a credit or debit card, and many also use Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA). Choosing the best credit card processing for therapists is not just about convenience—it’s about compliance, protecting client trust, and keeping costs manageable.
If you’re a solo therapist or managing a group practice, picking the right payment processor can make billing easier, deposits faster, and record-keeping more accurate. But with so many options, it can feel overwhelming. This guide breaks down what therapists should look for in a processor, compares a few trusted providers, and gives you the tools to make the best decision for your practice.
Why Credit Card Processing Matters for Therapists
For therapists, payment processing is not just about swiping cards—it’s about:
- Client trust: Secure and professional payments show clients you value their privacy.
- Compliance: U.S. therapists must ensure HIPAA (Health Insurance Portability and Accountability Act) and PCI DSS (Payment Card Industry Data Security Standard) compliance when storing or processing client information.
- Cash flow: Faster deposits mean steadier income to cover rent, insurance, and practice costs.
- Flexibility: Accepting credit, debit, HSA/FSA cards, and even online payments supports accessibility for clients.
Without the right system, therapists risk higher fees, potential compliance issues, or frustrated clients.
Key Criteria Therapists Should Consider
When evaluating merchant services for therapists, here are the top factors to keep in mind:
1. HIPAA-Compliant Payment Processor
Not every processor meets HIPAA requirements. A HIPAA-compliant processor will:
- Sign a Business Associate Agreement (BAA) with you.
- Protect patient health information (PHI) during transactions.
2. Credit Card Processing Fees
Common pricing models include:
- Flat rate: Example, 2.9% + 30¢ per transaction. Predictable but sometimes higher.
- Interchange-plus: More transparent but harder to read.
- Monthly subscription + small per-transaction fee: Good for high-volume practices.
3. Contract Terms
Look for month-to-month contracts without early termination fees. Many legacy processors lock practices into long-term contracts with penalties.
4. Payment Methods Supported
Therapists should ensure the processor accepts:
- Major credit/debit cards (Visa, Mastercard, AmEx, Discover).
- HSA/FSA cards.
- Contactless and online payments.
5. Speed of Deposits
Some processors offer same-day or next-day deposits—important for maintaining steady practice cash flow.
6. Integration with Practice Management Software
Many therapists already use platforms like SimplePractice or TherapyNotes. Having built-in credit card processing saves time and reduces errors.
Best Credit Card Processing Options for U.S. Therapists
Below are several processors commonly used in therapy practices. Details are accurate as of 2025, but therapists should confirm current rates and terms directly with the providers.
1. Ivy Pay (Talktoivy.com)
Designed specifically for therapists.
- HIPAA Compliant? Yes, includes BAA.
- Fees: Around 2.75% per transaction (no monthly fees).
- Features: Client-friendly mobile app, easy to send payment requests, supports debit/credit cards, HSA/FSA.
- Pros: Simple setup, no monthly costs, built for therapy practices.
- Cons: Limited to therapists (not useful for multi-specialty clinics), fewer business tools.
2. SimplePractice (via Stripe Integration)
A popular practice management software with built-in payment processing.
- HIPAA Compliant? Yes, BAA included.
- Fees: About 2.95% + $0.30 per successful transaction.
- Features: Integrated with scheduling, notes, and billing. Accepts online payments, recurring billing, card-on-file.
- Pros: All-in-one platform, reduces admin work, automatically logs payments into records.
- Cons: Slightly higher fees than some standalone processors; requires subscription to SimplePractice software.
3. TherapyNotes (via CardConnect)
Another leading practice management software with payment integration.
- HIPAA Compliant? Yes, with BAA.
- Fees: ≈ 2.9% + 30¢ per transaction (as of 2025).
- Features: Integrated billing, online payments, recurring charges.
- Pros: Seamless with TherapyNotes platform, trusted in the U.S. therapy community.
- Cons: Tied to using TherapyNotes subscription.
4. Square
A general small-business processor that some therapists use.
- HIPAA Compliant? No direct BAA. Best for therapists who don’t need to store PHI within the processor.
- Fees: 2.6% + 10¢ for in-person payments; 2.9% + 30¢ online.
- Features: In-person terminals, invoicing, next-day deposits.
- Pros: Easy to use, transparent pricing, strong mobile app.
- Cons: Not fully HIPAA-compliant unless paired with outside safeguards.
5. Stripe (Standalone)
Widely used processor, also the backbone for many therapy software integrations.
- HIPAA Compliant? Not by default. A BAA is available only for enterprise-level plans.
- Fees: 2.9% + 30¢ per transaction.
- Features: Online payments, recurring billing, card-on-file.
- Pros: Developer-friendly, flexible, reliable.
- Cons: Not therapy-specific, requires technical setup if not using a platform like SimplePractice.
Comparison Snapshot
| Processor | HIPAA Compliant | Typical Fees | Software Integration | Best For |
|---|---|---|---|---|
| Ivy Pay | Yes (BAA) | ~2.75% per transaction | Standalone app | Solo therapists seeking simplicity |
| SimplePractice | Yes (BAA) | 2.95% + $0.30 | Full platform | Therapists who want all-in-one solution |
| TherapyNotes | Yes (BAA) | ≈2.9% + $0.30 | Full platform | Practices already on TherapyNotes |
| Square | No BAA | 2.6% + 10¢ (in-person) | POS + invoicing | Non-HIPAA practices, basic card readers |
| Stripe | Limited (BAA only at higher tiers) | 2.9% + $0.30 | Flexible API | Tech-savvy practices, custom setups |
How to Save Money on Credit Card Processing Fees
- Read the fine print: Look out for monthly fees, statement fees, or hidden charges.
- Negotiate rates: Some providers will lower your percentage if you process high volume.
- Avoid long contracts: Stick to month-to-month services when possible.
- Batch deposits smartly: Fewer, larger deposits can sometimes reduce costs.
- Use integrated software: Saves admin time, even if fees are slightly higher.
Compliance Made Simple: HIPAA and PCI DSS
- HIPAA: Protects client health information. Your processor must sign a BAA if PHI is involved.
- PCI DSS: Security standard for handling card payments. Even if HIPAA doesn’t apply, PCI compliance is mandatory.
- Practical Tip: Always ask your processor directly if they’ll sign a BAA. If not, use a platform like Ivy Pay or SimplePractice.
FAQs About Credit Card Processing for Therapists
1. What does HIPAA-compliant credit card processing mean?
It means the processor is willing to sign a Business Associate Agreement (BAA) and ensures encryption, data security, and safeguards for client health information tied to payments.
2. How much should therapists expect to pay per transaction?
Most processors charge between 2.6%–3% + $0.30 per transaction. For a $100 session, expect to pay about $3 in processing fees.
3. Is it better to use a therapy-specific processor or a general one?
Therapy-specific options like Ivy Pay, SimplePractice, and TherapyNotes often include HIPAA compliance and practice integrations. General processors like Square or Stripe may be cheaper but don’t always meet HIPAA requirements.
4. Can I save money by negotiating my processing rate?
Yes. High-volume practices may be able to negotiate lower per-transaction fees, especially with interchange-plus models.
5. What features should therapists prioritize?
- Card-on-file for returning clients.
- Recurring billing for ongoing therapy sessions.
- HSA/FSA card acceptance.
- Secure, HIPAA-compliant systems.
6. What happens if I use a non-HIPAA-compliant processor?
You risk violating federal law if PHI is involved. This could result in fines and loss of client trust. Always confirm compliance before signing up.
Final Thoughts
The best credit card processing for therapists isn’t a one-size-fits-all decision.
- Solo practitioners may prefer Ivy Pay for its simplicity and no monthly fee.
- Therapists using practice management software like SimplePractice or TherapyNotes should stick with their built-in processors for convenience and compliance.
- Tech-savvy practices may choose Stripe or Square if HIPAA isn’t a concern.
By prioritizing HIPAA compliance, transparency in fees, and integration with your existing systems, you can protect your clients, save money, and keep your practice running smoothly.
Emma Rose is a U.S.-based personal finance writer and a regular contributor at Cardix.us. She focuses on topics like credit cards, credit scores, and everyday money management. Emma’s writing makes complex financial concepts simple and practical, helping readers make smarter credit and spending decisions with confidence.
