How to start a private practice: the setup steps and the launch plan

Before you start: is private practice right for you?

Owning a practice means running a small business on top of clinical work. Before signing a lease, answer four questions honestly:

• Do you have a patient base or a referral path? A practice opening with no following needs marketing from day one, and a longer runway.
• Insurance or self-pay? In-network practices wait on credentialing before revenue flows. Self-pay practices can bill sooner but must earn every patient on value and price.
• Who runs the business side? Billing, payroll, compliance and marketing take hours each week. Decide which you'll do, hire or outsource.
• What does your state allow? Ownership, supervision and scope rules decide whether your model is legal at all, especially for med spas and ABA companies.

If the answers are uncertain, spend a month on them. Changing course after a lease and loan is expensive.

The setup steps at a glance

The order matters, because later steps need earlier ones. Each links to where you verify it:

Licensing, NPI and payer credentialing

Licensing. Your professional license comes from your state board. For telehealth, ask your board whether you also need a license where the patient is located. Physicians can find every state medical board through the Federation of State Medical Boards directory. Other professions have their own boards; the practice-type guides below link them. If you'll prescribe controlled substances, you'll also need DEA registration, and your state may have its own controlled-substance requirements.

NPI. The National Provider Identifier is the 10-digit number used in HIPAA transactions. You apply for or update it in NPPES, where CMS says you can "create and maintain NPI data." Keep the practice address and phone in your record current, because directories copy it.

Medicare enrollment. CMS's steps: get an NPI, complete the application in PECOS (the online enrollment system), pay any application fee, then work with your Medicare Administrative Contractor (MAC), which may ask for more information. CMS says changes of ownership, adverse legal actions and practice-location changes must be reported within 30 days.

Commercial payers. Many health plans pull your credentials from CAQH ProView. CAQH says the first profile takes about two hours to complete; dentists sign in through the American Dental Association's portal. Credentialing then runs payer by payer. It often takes several months; confirm timelines with each payer and start as soon as your license and location details allow.

Location, insurance coverage and HIPAA basics

Location. Check zoning, parking, accessibility and signage rules before signing. Google requires a physical location with clear signage to list a business at a co-working space, so a shared suite affects your Google listing too.

Insurance coverage. At minimum, professional liability (malpractice), general liability, property, workers' compensation once you hire, and cyber coverage given that you'll hold patient data. Ask a broker who covers your specialty what your payers and landlord require.

HIPAA basics. As a covered entity, you need:

• a risk analysis and written safeguards under the Security Rule (HHS publishes Security Rule guidance (opens in a new tab), including a paper on implementation for small providers, and links its Security Risk Assessment Tool);
• privacy policies and a Notice of Privacy Practices;
• a Business Associate Agreement (BAA) with every vendor that handles patient information: EHR, billing, phones, email, forms, and your website if it collects patient data;
• staff training before the first patient.

Our HIPAA basics guide covers each in plain language.

This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.

Money: startup costs and runway

Honest startup-cost figures depend on specialty, city, space and equipment, so this page doesn't quote a range. Startup costs vary by market; any figure you rely on should come from a named, dated source for your specialty, such as your professional association, or from local quotes. Build your budget from these categories:

Runway is the line most new owners underestimate. Insurance claims are paid after visits, and only once payer contracts are active. A simple test: runway in months = cash available ÷ monthly fixed costs, before counting any collections. If that number is shorter than your credentialing and ramp-up period, you need more cash, a self-pay bridge or a later opening date. Have an accountant who works with practices check your plan.

The marketing launch plan

This is where startup guides go quiet, and where new practices win or lose their first year. Marketing for a new practice should start about 90 days before opening. The full week-by-week version is our 90-day marketing launch checklist; the essentials:

1. Secure the name, domain and website

Check that the practice name is available as a business name, a domain and a Google listing before you print anything. Then build a website with:

• a page per service, written in the words patients search;
• provider bios with credentials and photos;
• address, map, hours, parking and accessibility notes;
• insurance accepted, or self-pay prices;
• a phone number and booking or request button at the top of every page;
• a HIPAA-compliant appointment-request form, covered by a BAA with whoever stores it.

2. Set up your Google Business Profile early

Google lets you add an opening date up to one year ahead (opens in a new tab); after you verify, your profile appears on Google 90 days before that date. Patients can't post reviews or photos until you open, and a "Recently opened" label shows for 90 days after. Google's guidelines (opens in a new tab) require that you can be contacted at the verified location during your stated hours. Our guide to Google Business Profile for doctors covers categories, services and photos.

3. Make your data consistent everywhere

Your NPI record, payer directories, specialty directories and Google listing should show the same name, address and phone. Patients, payers and AI assistants all cross-check them.

4. Plan your first reviews, ethically

Ask every satisfied patient for a review once you open. Never offer incentives, never write reviews yourself, and never confirm in a reply that the reviewer is a patient. Using a patient's testimonial or photo in your own marketing requires a signed HIPAA authorization (45 CFR 164.508).

5. Run first campaigns where intent is highest

Start with Google Ads on searches that signal a ready patient ("[service] near me," "[specialty] [town]") with a monthly ceiling you control. Social ads can build awareness, but Meta's rules bar ads that assert or imply personal attributes (opens in a new tab), including health conditions: "Depression counseling" is allowed, "Depression getting you down?" is not.

6. Measure from day one

Count calls, forms, bookings and direction requests by source, and ask every new patient how they heard about you. For the bigger picture, our healthcare marketing guide covers each channel.

Where Medfy fits

Medfy builds or rebuilds a practice's website and hosts it on the practice's own domain, with a page per service and HIPAA-compliant forms; you see a free preview before paying. The base plan is $349 a month and also covers weekly SEO articles you approve, AI visibility tracking, analytics and Google reporting. Medfy signs a BAA with each practice before any patient data flows. Start with the free audit and website preview, and see Medfy pricing for add-ons.

Guides by practice type: medical, therapy, dental, med spa, ABA, PT

Each guide covers that profession's official steps, then the launch marketing that fits it:

• Starting a medical practice: a 12-month timeline from license and DEA registration to Medicare enrollment, EHR, staffing and launch.
• Starting a therapy practice: licensure, insurance panels or private pay, Good Faith Estimates, telehealth and ethics-safe ways to find first clients.
• Opening a dental practice: startup vs acquisition, financing, buildout, credentialing and a launch plan for a new dental office.
• Opening a med spa: state ownership and medical director rules first, a business plan outline, and launch marketing that fits ad policies.
• Starting an ABA company: BCBA and RBT credentials, state licensure, Medicaid and payer credentialing, and referral-led growth.
• Starting a physical therapy practice: cash-based vs in-network, direct access in your state, Medicare enrollment and physician referrals.

Frequently asked questions

How do I start a private medical practice?

Confirm your state license and, if you'll prescribe controlled substances, DEA registration. Form the business entity, get an NPI through NPPES, enroll in Medicare through PECOS and credential with commercial payers through CAQH ProView. Secure a location, malpractice and business insurance, an EHR and HIPAA safeguards. Start marketing about 90 days before opening with a website, a Google Business Profile and accurate directory listings.

How much does it cost to start a private practice?

It varies too much by specialty, market and build-out to give one honest figure. A telehealth-only therapy practice and a dental office with operatories are different businesses. List the cost categories (entity and licensing fees, lease and build-out, equipment, software, insurance, staff, marketing and working capital), get local quotes for each, and confirm totals with a lender or accountant who works with your specialty.

How long does insurance credentialing take?

Often several months, and it differs by payer and state, so start as early as your license and practice details allow and confirm timelines with each payer. Keep your CAQH ProView profile complete and current, because many commercial plans pull from it. Until contracts are active, plan for little or no in-network revenue, and decide whether to see self-pay patients meanwhile.

Do I need a website before my practice opens?

Yes. Patients check a practice online before they call, and payers, referring providers and Google all look for one. Launch at least a simple site before opening day: a page per service, provider bios, address, hours, insurance or self-pay information, and a HIPAA-compliant way to request an appointment. Your Google Business Profile can link to it from 90 days before opening.

What licenses do I need to open a private practice?

You need an active professional license from your state's board for your profession, plus any state business registrations your entity needs. Physicians and others who prescribe controlled substances also need DEA registration, and your state may have its own controlled-substance requirements. Facility, lab (CLIA) or local permits may apply depending on services. Requirements vary by state, province and profession, so confirm each with the issuing agency.