SBA lenders approved 1,248 7(a) loans to offices of mental health practitioners other than physicians between October 2023 and June 2026, about $311 million from 219 lenders. The median loan was $118,500, below the national $150,300, at a median rate of 10.5% against 10.25% nationally, and 35% went through SBA Express. Acquisitions were only 3% of loans, against 10.4% nationally, but their median was $750,000. Lenders decide on payer mix and credentialing, whether clinicians are employed or contracted and likely to stay, and how much of the revenue is the owner's own caseload.
| Measure | Offices of Mental Health Practitioners (except Physicians) | All industries |
|---|---|---|
| SBA 7(a) loans approved | 1,248 | 162,355 |
| Median loan | $118,500 | $150,300 |
| Middle half of loans | $50,000 – $298,950 | $50,000 – $500,000 |
| Loans of $1 million or more | 4.9% | 12.9% |
| Median rate at approval | 10.5% | 10.25% |
| Middle half of rates | 9.5% – 12% | 9.3% – 11.25% |
| Acquisitions (change of ownership) | 37 (3%) | 16,849 (10.4%) |
| Median acquisition loan | $750,000 | $693,000 |
| Lenders that made these loans | 219 | 1,648 |
| SBA 504 loans (real estate, equipment) | 167 | 16,714 |
Approvals FY2024 – FY2026 to date (1 Oct 2023 – 30 Jun 2026), cancelled loans excluded. Source: SBA 7(a) and 504 FOIA loan records, as of June 30, 2026.
- SBA 7(a) loans approved
- 1,248 (Oct 2023 – Jun 2026)
- Median loan
- $118,500 (national $150,300)
- Median rate at approval
- 10.5% (national 10.25%)
- SBA Express share
- 35% of loans
- Acquisitions
- 37 loans (3%), median $750,000
- SBA 504
- 167 loans, median $337,000
Small loans, and more building purchases than acquisitions
NAICS 621330 covers psychologists, licensed clinical social workers, marriage and family therapists, professional counselors and similar clinicians practicing outside a physician's office. SBA lenders approved 1,248 7(a) loans to them from FY2024 through June 2026, worth $311,194,100, from 219 lenders.
| Figure | Mental health practitioners | National | Reading |
|---|---|---|---|
| Median loan | $118,500 | $150,300 | Below national: office set-up, working capital, a second location |
| Middle half of loans | $50,000 to $298,950 | A quarter of loans were $50,000 or less | |
| 90th percentile | $580,750 | ||
| Loans of $1 million or more | 61 (4.9%) | Uncommon in a field of small loans | |
| Median rate | 10.5% (middle half 9.5% to 12%) | 10.25% | A quarter of loans priced at 12% or more |
| Fixed-rate share | 12.8% | ||
| SBA Express | 35% of loans | Small requests on the lender's own process | |
| Start-ups | 10.2% of loans | New practices; lenders look for a clinician who already has a caseload | |
| Acquisitions | 37 (3%), median $750,000 at 10% | 10.4% of loans | Rare, and large when they happen |
| SBA 504 | 167 loans, median $337,000 | More 504 loans than acquisitions | |
| Median jobs supported | 5 | Larger teams than the loan size suggests |
Two numbers stand out. The median loan supported 5 jobs, more than the small loan size would suggest, which suggests many borrowers are group practices with several clinicians rather than solo offices. And there were 167 SBA 504 loans against 37 acquisitions: practice owners in this field are far more likely to buy their building than to buy another practice.
A solo clinician and a group practice are different credits
A solo therapist's practice is underwritten almost entirely on the person: their license, their caseload and their household finances. The loan is usually small, often SBA Express, and SBA's global test, 1.0x coverage including the owner's personal obligations, frequently decides it. Small loans also carry the widest rate caps: SBA allows variable rates up to the base rate plus 6.5% for loans of $50,000 or less and plus 6% from $50,001 to $250,000. In this field a quarter of loans were $50,000 or less and a quarter priced at 12% or more, well above the national median of 10.25%. See global cash flow.
A group practice is a business with a payroll. The owner may carry a caseload, but most revenue comes from associate clinicians, and the lender's questions move from the owner's skill to the practice's systems: how it recruits and keeps clinicians, how it bills, and whether its revenue would survive the loss of one or two of them. SBA requires business debt service coverage of at least 1.15x on the practice's own cash flow.
What an underwriter tests in a therapy practice
| Question | Why it matters | What answers it |
|---|---|---|
| Who pays, and how reliably? | Commercial insurance, Medicaid, Medicare, employee assistance programs and private pay collect at different rates and speeds | Collections by payer for two full years, with denial rates |
| Are payer contracts in the practice's name? | Credentialing often attaches to each clinician, and sometimes to the group; revenue can depend on who is credentialed where | A list of payer contracts and which clinicians are credentialed under each |
| Are clinicians employees or contractors? | Contracted clinicians can leave with their clients; misclassification is a liability | A clinician roster with status, tenure, license and caseload |
| How much is the owner's own caseload? | Revenue the owner produces personally is only as durable as the owner | Revenue by clinician |
| How much is telehealth, and where are clients? | A clinician generally needs a license where the client is located | Telehealth share and client states |
Retention is the thread through all of it. A group practice that has kept its clinicians for years, with employment agreements and reasonable non-solicitation terms, underwrites very differently from one with high turnover and 1099 contractors who bring and take their own clients.
In a group practice, the lender is financing the clinicians. Show who they are, how long they have stayed and what ties them to the practice.
Why acquisitions are rare, and large
Only 37 loans, 3% of the total, financed a change of ownership, at a median of $750,000 and a median rate of 10%. That is more than six times the industry's median loan. Solo practices rarely sell for enough to finance: clients chose the therapist, and a buyer cannot count on them staying. What does get bought is a group practice with a clinical team, a referral base and payer contracts, and those are priced accordingly.
Such an acquisition carries the standard SBA terms and some specific to the field:
- Ownership rules. Whether a non-clinician can own a therapy practice depends on the state and the licenses involved. Lenders will ask how the structure complies before anything else.
- Payer contract transfer. In a stock purchase contracts usually stay with the entity; in an asset purchase the buyer may have to re-credential, and revenue can dip while that happens. See asset versus stock purchase financing and change-of-control consents.
- Equity and seller terms. At least 10% of total project costs; a seller note counts toward up to half only on full standby for the life of the loan; no earnout to the seller.
- Valuation. Where the amount financed, less appraised real estate and equipment, exceeds $250,000, an independent business valuation is required, and the purchase loan cannot exceed it.
- Seller transition. The seller may consult for up to 12 months, or up to 24 months under SOP 50 10 8.1 from 1 October 2026, but may not stay as an owner, officer or employee.
- From 1 October 2026, financial due diligence on every change of ownership and 1.25x coverage on historical results.
See financing a medical practice acquisition for the wider deal mechanics.
Buying the office instead
167 504 loans at a median of $337,000 make building ownership the most common large borrowing in this field. A therapy practice suits a small office condominium or a converted house, and a 504 loan is typically 50% from a bank, 40% from the CDC and 10% from the practice, or 15% for a new business. The practice must occupy at least 51% of an existing building, or 60% of new construction, so a group can lease the rest to other clinicians. A 7(a) loan can also finance real estate, over up to 25 years. See SBA 7(a) vs 504.
Preparing a therapy practice's SBA file
SBA's standard list: business tax returns for 2–3 years, a P&L and balance sheet with a year-to-date P&L through last month-end, a debt schedule with copies of notes being refinanced, and personal tax returns and a personal financial statement for each owner of 20% or more. For a mental health practice, add:
- Collections by payer for the last two full years
- A clinician roster: license, employee or contractor, start date and caseload
- Payer contracts and credentialing status by clinician
- Employment or independent contractor agreements for clinicians
- For an acquisition, the letter of intent and the target's latest full year of figures, never an older year
Practices using merchant cash advances to cover slow insurance payments need to resolve them first; SBA will not refinance an active advance. See refinancing cash advances for healthcare providers, or lines of credit for medical practices for a steadier way to carry receivables.
Transparent builds the full lender package, financing model, lender presentation, blind teaser and underwriting memo, in a day once the documents are in, and takes it to the 278 lenders in its book that write SBA 7(a) and 504. On SBA loans the lender pays Transparent, not the borrower. Neighboring pages: outpatient mental health centers and psychiatrists.
Common questions
- Can a therapist get an SBA loan to start a private practice?
- Yes. Start-ups were 10.2% of loans in this field from October 2023 to June 2026. Lenders look for a current license, an existing or transferable caseload, at least 10% equity injection, and household finances that pass SBA's global coverage test.
- What is a typical SBA loan for a counseling practice?
- Small. The median was $118,500, against $150,300 nationally, with the middle half between $50,000 and $298,950. 35% of loans went through SBA Express.
- Why are SBA rates higher for small therapy practice loans?
- SBA allows higher maximum rates on smaller loans: base plus 6.5% up to $50,000 and base plus 6% from $50,001 to $250,000. The industry median rate was 10.5%, and a quarter of loans priced at 12% or more.
- Can I buy a group therapy practice with an SBA loan?
- Yes, though it is uncommon: 37 loans, 3% of the total, at a median of $750,000. Lenders focus on clinician retention, payer contracts and whether the ownership structure complies with state licensing rules.
- Do lenders care whether my clinicians are W-2 or 1099?
- Yes. Contracted clinicians can leave with their clients more easily, and misclassification creates a liability. Lenders want a roster showing each clinician's status, tenure and caseload.