How to Build a 2026 Budget That Keeps Your Practice Profitable All Year
If your practice always feels like it’s chasing money instead of managing it, you’re not alone. Most psychiatry offices don’t have a real budget. They just react to expenses as they happen. But a proper 2026 budget gives you control. It helps you plan where your money goes so you can stay profitable all year, not just when patient volume is high.
Start with Last Year’s Numbers
Before you can plan ahead, you need to look back. Pull your 2025 P&L and focus on key numbers:
Total income for the year
Total expenses
Net profit
Bank deposits month by month
Notice the trends. Did revenue dip during the summer? Did expenses spike in Q4? Use these patterns to build realistic monthly targets instead of vague annual goals.
Focus on the Big Three Categories
Every practice’s budget has hundreds of line items, but most spending falls into 4 main categories:
People – salaries, benefits, and contractors
Lead Generation – marketing and advertising
Office Expenses - rent, equipment, utilities
Platform – your tech stack, EHR, CRM, and operational tools
If your team and your systems are efficient, these four areas will produce consistent profits. If one area is bloated or unmanaged, it will eat into your margins fast.
Calculate Your Revenue
You should know how many providers you have, what their schedule is, how long is each appointment, and the average reimbursement for each appointment type. Based on this you can calculate the maximum amount of revenue each provider can generate and then reduce it by 20% to account for no-shows and late cancellations.
Budget for Taxes
Don’t get caught off guard in April. Taxes are one of the biggest expenses that can derail your cash flow if you don’t plan for them. Build them right into your monthly budget.
A simple rule of thumb: set aside 25-30% of your net income every month in a separate tax savings high yield account. This way, when quarterly or year-end payments come due, the money is already waiting for you.
If you work with a tax strategist, review your budget together every quarter. They can help you make smart decisions that reduce taxable income through business investments, retirement contributions, or new equipment.
Add a Growth Fund
Once your core operations and tax savings are covered, create a small monthly reserve for growth. This is your money for upgrades, new hires, or marketing pushes.
Even $1,000 a month adds up to $12,000 by year’s end, enough to invest in new patient acquisition systems or AI tools that make your staff more efficient.
Track It Monthly, Not Annually
The biggest mistake practices make is setting a budget in January and not looking at it again until tax season. Treat your budget like a living tool, not a document that collects dust. Compare your P&L to your budget to see how far off you are. This should force you to ask questions on how you got there and how to do better.
Bottom Line
A budget is not just about cutting costs. It’s about making your practice stronger, more predictable, and more profitable. If you plan your profit first, budget for taxes, track monthly, and invest in the right systems, your 2026 budget will work for you, not against you.
Take the Next Step: Let’s Talk
If you’re ready to turn your practice into a high-performing business, let’s talk.
Our Business Coaching program helps psychiatry practice owners streamline operations, boost profits, and build confident, accountable teams.
Schedule a free 30-minute strategy call to see how MindPractice can help your practice grow.
