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What Goes Into Starting an Art Therapy Practice

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An art therapy practice is a clinical mental health business where a credentialed art therapist uses visual art media and the creative process as the primary therapeutic tool. Sessions are conducted in a private, scheduled setting — with individual clients, families, or small groups — and every aspect of the work is governed by professional ethics, privacy law, and clinical standards.

This is not a casual creative studio. Your clients come to you carrying real mental health challenges. Children struggling with behavioral issues, adults working through trauma, older adults managing grief or cognitive decline — they choose you because they trust that you have the training, the space, and the professional structure to help them. That trust starts before the first session ever begins.

The startup path for this kind of practice is more involved than most health and wellness businesses. It combines graduate-level professional credentialing, federal privacy compliance, insurance billing systems, and the physical demands of a working art studio. Before you sign a lease or stock a single supply shelf, you need to understand all of it.

Is an Art Therapy Practice a Good Fit for You?

Art therapy draws people who love both creative expression and clinical mental health work. That combination is the foundation of the profession — and it’s also what makes it demanding to run as an independent practice.

Ask yourself honestly: Do you have the graduate-level clinical training and the right credentials to practice independently in your state? Do you have the business tolerance to manage scheduling, billing, documentation, and compliance entirely on your own? Can you cover your personal living expenses for six months to a year while you build a caseload from scratch?

A new private practice rarely opens with a full schedule. Most art therapists build their client base gradually over many months. If your household can’t absorb a slow start financially, or if the people who depend on you aren’t prepared for the income uncertainty that comes with launching a practice, now may not be the right time.

The clinical side of the job is rewarding. The administrative side — credentialing with insurance companies, writing notes after every session, managing billing and claims — is real and time-consuming. Private practice therapists typically spend five to 10 hours a week on business administration beyond direct client hours. That’s before accounting for art supply management, which is an ongoing operational responsibility with no equivalent in talk-therapy practices.

You should also think about what kind of practice owner you want to be. A solo private practice gives you full autonomy over your schedule, your fees, your client population, and your clinical approach. A group practice offers more referral flow and administrative sharing, but it adds complexity, staffing decisions, and higher overhead from day one. Most new art therapists start solo.

Talk to art therapists who run their own practices — ideally in different geographic areas so there’s no competitive overlap. Ask them what the first year looked like financially. Ask them what they wish they had known before opening. Firsthand owner insight is more useful than anything you’ll read in a general business guide, because each person’s path through credentialing, insurance, and caseload-building is different.

What Clients Will Notice First

Your clients — and the parents, physicians, and social workers who refer them — form their first impressions quickly. Before they ever sit down in a session, they’re already evaluating whether you’re a professional they can trust.

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  • Whether you could clearly explain your credentials and what licenses or certifications you hold
  • Whether your office space feels private, calm, and set up for real art-making — not a converted storage room
  • Whether your intake process was smooth, clear about fees, and asked the right questions about their needs
  • Whether the paperwork explained your privacy practices and what to expect in a session
  • Whether art supplies were organized, appropriate, and ready before the session started
  • Whether the space felt safe for a child, an anxious adult, or someone in crisis
  • Whether your cancellation policy, fee structure, and insurance process were explained upfront

Clients who feel uncertain about any of these things may not rebook. Clients who feel reassured will refer others. Building that trust systematically — through your space, your intake process, and your documentation — is what separates a professional practice from a hobbyist setup.

Red Flags Before You Start

Some issues should make you pause, slow down, or change your approach before committing to the full startup investment.

You don’t yet hold the required credential or license for your state. Art therapy licensure is not consistent across the U.S. Fewer than 15 states have standalone art therapy licenses. In most states, you need a broader mental health license — an LPC, LMHC, LCSW, or similar — to operate a therapy practice independently. If you don’t have what your state requires, you can’t legally open. Map your credentialing path and timeline before spending anything on a lease or buildout.

Your state requires a license you may not qualify for due to recent CACREP changes. Changes to national counseling accreditation standards now mean most art therapists can’t obtain an LPC license unless they graduated from a CACREP-accredited program — which most art therapy programs are not. This has created real barriers for some practitioners. Understand exactly how this affects your situation before investing in a practice.

You can’t sustain personal expenses during a slow launch. New practices rarely open with a full caseload. If you have no financial cushion and no secondary income, launching solo before you have a referral base is a high-risk decision. Consider building a client base part-time first, or starting as an associate in a group practice before going independent.

Insurance credentialing may be harder than you expect. Even in states where art therapy is licensed, some insurance panels may not credential art therapists, may require a specific license type, or may reimburse at very low rates. Verify with your target payers before building your financial model around insurance revenue.

Your break-even math doesn’t work at a realistic session volume. Run your actual numbers before signing a lease. If your fixed monthly costs — rent, insurance, EHR software, supplies, phone — require more billable sessions than a new practice can realistically fill, you’ll operate at a loss. A shared therapy suite or telehealth option can reduce this risk while you build volume.

Your space can’t accommodate art-making without costly modifications. Generic therapy offices aren’t built for paint, clay, and water cleanup. If you can’t find space with the right flooring, ventilation, sink access, and storage — or if modifying the space is prohibitively expensive — the location isn’t right.

Art supply costs are rising and will pressure your margins. Therapeutic-grade supplies have seen significant price increases in recent years. This is an ongoing expense unique to art therapy practices that general therapy cost models don’t account for. Budget it carefully.

Step 1: Confirm Your Credentials and Readiness to Practice Independently

Before anything else, you need to know exactly where you stand clinically and professionally.

You must hold — or be actively working toward — a master’s degree from a CAAHEP-accredited or AATA-approved art therapy program. That graduate education is the foundation for every credential that follows.

The three national credential levels to understand are:

  • ATR-Provisional (ATR-P) — for graduates who have completed their degree and are accumulating post-graduate supervised hours toward full registration
  • Registered Art Therapist (ATR) — awarded after completing a minimum of 1,000–1,500 direct client contact hours and the required supervision hours post-graduation
  • Board Certified Art Therapist (ATR-BC) — the highest national credential, requiring passage of the Art Therapy Credentials Board Examination (ATCBE)

These credentials are issued by the Art Therapy Credentials Board (ATCB). They are professional credentials — not licenses. Whether any of them are sufficient to operate an independent practice in your state depends on your state’s specific laws.

Be honest about whether you’re clinically ready to work independently. Running a private practice means no supervisor down the hall, no institutional support systems, and no one else handling the clinical edge cases. If you’re newly credentialed, consider working in a group practice or community setting first to build confidence before going solo.

Step 2: Determine Your State’s Practice and Title-Protection Requirements

This step can make or break your timeline. Do not skip it.

Art therapy licensure varies dramatically by state. In states with a standalone art therapy license — including New Mexico, Connecticut, Delaware, Kentucky, Maryland, Mississippi, Nebraska, New Jersey, Ohio, Oregon, Tennessee, Virginia, and Washington, D.C. — you’ll need that specific license to legally call yourself an art therapist and practice in that role. In most other states, you’ll need a broader mental health credential such as an LPC or LMHC to practice therapy independently, even with full ATR-BC credentials.

The landscape is changing. Several states added art therapy licensure in 2023 and 2024, and more advocacy is underway. Check the ATCB’s Licensure Requirement by State page and your state’s health professions licensing board directly — not just this article — for current requirements in your specific state.

If your state requires a license you don’t yet hold, find out exactly what supervised hours, exams, or additional coursework are needed and build that into your launch timeline. Referring providers and clients expect to verify your credentials. You need to be fully licensed before your first session.

Step 3: Talk to Art Therapists Who Run Their Own Practices

Before you commit to any lease, buildout, or major purchase, talk to people who have already done this.

Seek out art therapists in private practice who are based in different geographic areas — so there’s no competitive concern for either of you. Prepare specific questions before you reach out. Ask how long it took them to fill their caseload, how they handle insurance credentialing, what EHR platform they use, what their monthly art supply budget looks like, and what they would do differently if starting over.

These conversations will give you information that no research document can. Each owner’s path is different, but patterns in those stories — about what’s harder than expected, what costs more than projected, where clients actually come from — are invaluable before you make major commitments.

Step 4: Choose Your Practice Model and Scope of Services

The model you choose shapes your startup costs, your daily workload, and what your clients experience from the moment they contact you.

Three model decisions to make before anything else:

  • Solo vs. group practice. A solo practice is lower in overhead and simpler to operate, but your income is tied entirely to your own caseload. A group practice shares administrative overhead but adds staffing complexity and higher fixed costs from the start.
  • In-person, telehealth, or hybrid. Telehealth reduces facility costs but has practical limitations for art therapy — clients need supplies at home, and the tactile, observational quality of in-person art-making is reduced. Hybrid is common. Verify your state’s telehealth rules for mental health services before marketing virtual sessions.
  • Client populations and service types. Who you serve shapes everything: space needs, supply inventory, insurance panel eligibility, and where your referrals come from. Children, adults with trauma histories, older adults with dementia, veterans, and oncology patients all have different clinical and environmental needs.

You also need to decide your payment model early: private pay only, insurance-based, or a mix of both. A private pay-only practice is simpler to administer, generates faster cash flow, and avoids the long credentialing process. An insurance-based practice can make your services more accessible to clients who couldn’t otherwise afford them, but it adds weeks of administrative work, delayed reimbursements, and panel eligibility barriers that vary by state and credential.

Step 5: Assess Local Market Demand and Competition

Understanding your local market before you open — not after — is how you avoid committing to an area that can’t support your practice.

Research the existing mental health providers and art therapists in your target area. Are there gaps in services? Are there underserved populations that align with your intended specialization? An area saturated with licensed counselors may still have very few credentialed art therapists — that can be an advantage if you position and communicate clearly.

Identify your likely referral sources. Primary care physicians, pediatricians, school counselors, hospitals, psychiatric facilities, social workers, veterans’ services, and domestic violence programs are all common referral channels for art therapists. Local demand verification matters before you commit to a location.

Step 6: Build Your Business Plan

A solid business plan is how you confirm — before spending significant money — that the practice can actually support itself financially.

Start by projecting your startup costs: credential application fees, business entity formation, lease deposit and early rent, furniture and art supplies, EHR software, malpractice insurance, and working capital to cover your own living expenses during the ramp-up period. Then estimate how many sessions per week you need to cover those fixed monthly costs and pay yourself.

According to the 2025 Financial State of Private Practice Report, the average private pay rate across therapy types ran about $159 per session, while the average insurance reimbursement rate was roughly $111 — about 36% less. Your actual break-even will depend on your specific fee, your fixed costs, and how quickly you fill your schedule.

Insurance-based practices also carry delayed reimbursement cycles — sometimes 30 to 90 days from claim submission to payment. You need enough working capital to float that gap in the early months. If that’s not feasible, starting as private pay only and adding insurance panels later is a sound approach.

Determine how long you can sustain reduced income while building a caseload. Most new private practices take six to 12 months to reach a full schedule. If that timeline doesn’t work financially, revisit the model — perhaps a phased launch, a part-time start, or a shared space arrangement that lowers overhead.

For more on building a financial projection for your practice, see estimating profitability for a new business.

Funding options worth exploring include personal savings, SBA microloans, and small business development center programs. A business loan may also be appropriate if you need to cover buildout costs or equipment before your caseload generates revenue.

Step 7: Handle Business Registration, Legal Structure, and Tax Setup

Your practice needs a legal identity before you can open a bank account, sign a lease, or bill insurance.

Choose a business entity. Most licensed health professionals use an LLC or a Professional Limited Liability Company (PLLC), depending on what their state requires for licensed practitioners. Register through your state’s Secretary of State website. If you’ll operate under a name other than your own, you’ll need to register a DBA as well.

Apply for an Employer Identification Number (EIN) from the IRS. You’ll use it for business banking, tax filing, and credentialing applications. Then open a dedicated business bank account and keep all practice transactions completely separate from your personal finances from day one.

Set up payment processing as part of this step. Most practice management platforms include integrated payment tools, but you’ll need a business account in place before processing is active.

Step 8: Apply for Your National Provider Identifier

Your National Provider Identifier (NPI) is a 10-digit number issued by the Centers for Medicare and Medicaid Services (CMS). It identifies you as a healthcare provider for billing purposes and is required for all HIPAA-covered providers.

You need an individual NPI (Type 1) to bill insurance and conduct any transactions involving client health data. If you’re opening a group practice or operating under an organizational name, a separate Organization NPI (Type 2) is also required.

Apply through the CMS NPI Enumerator system at nppes.cms.hhs.gov. Your NPI must be in place before you submit credentialing applications to insurance panels. Get it early — don’t treat it as a last-minute step.

Step 9: Obtain Malpractice and Business Insurance

Professional liability insurance — sometimes called malpractice insurance — is not federally mandated, but it’s effectively non-negotiable. Insurance panels require it for credentialing. Commercial leases often require it. And clients working through trauma, mental health crises, or significant life challenges are considered high-risk for potential claims.

Coverage types to secure before seeing clients:

  • Professional liability (malpractice): Covers claims of clinical negligence, errors, or omissions in your work as a therapist
  • General liability: Covers bodily injury and property damage at your practice location — required by most commercial leases
  • Cyber liability: Strongly recommended for any practice storing electronic protected health information; covers data breaches, ransomware, and related costs
  • Business property or Business Owner’s Policy (BOP): Covers your physical assets — computers, furniture, and art supplies
  • Workers’ compensation: Required in most states if you hire any employees

Disability insurance isn’t required, but it’s worth serious consideration. As a sole practitioner, your income stops entirely if you can’t work. For more on business coverage generally, see business insurance.

Step 10: Select Your Clinical Space and Confirm Lease and Zoning

Your space is one of the first things clients evaluate. A well-chosen room signals professionalism, safety, and that you take their experience seriously.

Art therapy has physical requirements that standard talk-therapy offices don’t. You need washable or easily cleaned flooring — carpet isn’t appropriate for a working art studio. You need storage for a substantial inventory of art materials, a sink with running water for cleanup, adequate ventilation for spray products or clay dust, and enough room for both a conversation area and an art-making work surface.

Sound privacy is non-negotiable. Clients need to feel that what they say and create in your space stays there. A white noise machine outside the door is standard practice.

Space options to evaluate:

  • Dedicated leased office — full control, but highest fixed cost commitment
  • Subleased space within a clinical or wellness suite — lower cost, but less flexibility for art-making modifications
  • Shared or hourly therapy room rental — lowest overhead while building volume, but limits your ability to store materials and personalize the environment
  • Home office — possible where local zoning permits, but must meet strict HIPAA privacy standards and may be restricted by home occupation rules

Before signing anything, verify that local zoning permits a mental health practice at the address. If you’re moving into a commercial space, check whether a certificate of occupancy is required for this use in your municipality. Both requirements vary by location — confirm with your local planning department and building office.

Step 11: Establish HIPAA Compliance Infrastructure

As a healthcare provider handling protected health information (PHI), you are a HIPAA-covered entity. This is a legal status with real compliance obligations — not a checkbox you can defer until you’re busier.

Your HIPAA obligations include written privacy and security policies, a Notice of Privacy Practices that you give to every client, secure physical and electronic storage of records, and signed Business Associate Agreements (BAAs) with every technology vendor that handles client data — including your EHR platform, telehealth tool, and encrypted messaging service.

Your physical space must support privacy. Separate your clinical area from any public or reception space. Use privacy screen filters on monitors visible from public sightlines. Sound attenuation matters here too — session conversations should not be audible in waiting areas or hallways.

Clients with mental health challenges are especially sensitive to privacy. If your space or your intake process gives even the impression that their information isn’t protected, you’ll lose their trust before the therapeutic relationship has a chance to form.

Step 12: Select and Configure Your Practice Management System

Your electronic health records (EHR) and practice management platform is the operational backbone of your practice. It handles scheduling, clinical notes, billing, insurance claims, and client communication — all in one HIPAA-compliant system.

Leading platforms used by solo behavioral health practitioners include SimplePractice, TherapyNotes, TheraNest, and TheraPlatform. Each has different pricing, billing capabilities, and telehealth integrations. Choose one that matches your billing model and your practice size.

Confirm before paying for any platform:

  • The vendor provides a signed BAA — this is a HIPAA requirement, not a formality
  • The platform includes or integrates with a HIPAA-compliant telehealth tool if you need one
  • It can generate superbills for out-of-network clients and Good Faith Estimates as required by federal law
  • Integrated payment processing is available so clients can pay securely at booking or after a session

Before your first client appointment, configure your intake forms, consent documents, fee schedule, progress note templates, and Good Faith Estimate templates inside the platform. A confusing intake process or a missing form on day one undermines the professionalism your clients are looking for.

Step 13: Complete Insurance Credentialing

If you plan to bill insurance, credentialing is the process of applying to become an in-network provider with specific insurance companies. It is not quick.

Start by creating a complete and error-free profile on CAQH ProView, which is the centralized credentialing system used by most private insurers in the U.S. Upload your malpractice insurance certificate, state license, resume, and any other required documents. Keep your attestation current — CAQH requires updates every 120 days.

The credentialing process typically takes 60 to 180 days with most payers, and some take longer. Submit applications well before your planned opening date if you want to bill insurance from day one. During the credentialing period, you can see clients as private pay and hold insurance claims until credentialing is approved.

Before you apply to any panel, verify that your credential and state license type qualifies you for enrollment with that specific payer in your state. Some insurers require a particular license type that art therapists may not hold in every state. Calling the provider relations line directly before you spend hours completing an application will save significant frustration.

Step 14: Prepare Your Client Documentation and Consent Forms

Your documentation package is what clients encounter before they ever see your space or meet you in person. It sets the tone for the therapeutic relationship and establishes your professional standards clearly.

Before your first session, have these forms ready:

  • HIPAA Notice of Privacy Practices
  • Informed consent and therapy agreement (fees, cancellation policy, limits of confidentiality, emergency procedures)
  • Biopsychosocial assessment and intake form
  • Treatment plan template
  • Progress note format for documenting each session
  • Assignment of Benefits form (for clients using insurance)
  • Release of information forms
  • Good Faith Estimate forms for all uninsured or self-pay clients

The Good Faith Estimate is a federal requirement under the No Surprises Act. You must provide it in writing to any client who is uninsured or not using their insurance — and you must inform them of this right both verbally and in writing before services begin. For ongoing clients, the estimate must be renewed every 12 months.

You are also a mandatory reporter as a licensed mental health professional. Before seeing your first client, confirm your state’s specific requirements for reporting suspected child abuse, elder abuse, and imminent safety risks. Requirements are not the same in every state. Verify the specific thresholds and reporting procedures with your state’s licensing board.

Have an attorney with healthcare or mental health practice experience review your consent forms and therapy agreement before you use them. The cost of that review is small compared to the risk of missing a legally required provision.

Step 15: Set Up Your Art Supplies and Clinical Studio Environment

The art materials you choose, and how you present them, directly affect what clients can accomplish in sessions and how they feel when they arrive.

Core materials to have stocked before your first client:

  • Drawing materials: colored pencils, crayons, markers, oil pastels, soft pastels, graphite pencils
  • Painting materials: acrylic paints, tempera paints, watercolors, brushes, palettes, mixing cups
  • Paper and substrates: sketch pads, watercolor paper, cardstock, construction paper
  • Collage and mixed media: magazines, scissors, glue, tape, tissue paper, fabric scraps
  • Sculpting materials: air-dry clay, Model Magic or similar, basic sculpting tools
  • Protective smocks or aprons for clients

Organize your materials so clients can see and access them without asking. The visual presentation of your supply area communicates something before the session starts — an organized, inviting studio signals that this is a clinical space designed for their work.

Store client artwork and session records separately, in secure, locked areas. Completed client artwork is part of the clinical record in some frameworks. This is both an ethical obligation and a HIPAA-related one.

If you work with children, older adults, or medically vulnerable clients, verify that your materials are non-toxic and appropriate for those populations. Keep Material Safety Data Sheets (MSDS) on file for any products with chemical hazard designations.

Step 16: Set Your Fees, Payment Systems, and Financial Records

Clients want to understand what therapy will cost before they commit. A clear fee structure, explained upfront, is part of the professional experience they’re evaluating.

Set your private pay session fee based on your local market rates, your credential level, and your cost of living. Average private pay therapy rates nationally ran about $159 per session in 2025, but rates vary considerably by city and state. Research what other licensed mental health providers in your area charge and set a rate that reflects your training and your market. For guidance on structuring your rates, see pricing your services.

If you offer a sliding scale, calculate its effect on your average session revenue before committing to a wide range. A generous sliding scale increases accessibility but reduces your average per-session revenue — and may not be financially sustainable in the early months.

Art therapy sessions are billed using standard psychotherapy CPT codes: 90791 for an intake evaluation, 90834 for a 45-minute individual session, 90837 for a 60-minute individual session, and 90853 for group sessions. Each code must be paired with an appropriate ICD-10 diagnosis code. Verify with each insurance payer which codes they accept for services billed under your credential type in your state.

Set up your bookkeeping system before your first paycheck arrives. Use accounting software to track income and expenses from the start, and set aside funds for quarterly estimated tax payments. Consult a tax professional who works with healthcare practitioners before you open.

Step 17: Complete Final Readiness Checks and Open Your Practice

Before you schedule your first client, run through the full readiness checklist systematically.

Confirm all of the following are in place:

  • Your credential and state license are current and in good standing
  • Individual NPI is active
  • Malpractice, general liability, and cyber liability insurance are active
  • BAAs are signed with your EHR vendor and any other PHI-handling platform
  • Your office lease is signed, zoning is confirmed, and any required certificate of occupancy is obtained
  • Your EHR is fully configured: intake forms, consent documents, fee schedule, and note templates
  • HIPAA Notice of Privacy Practices is ready to provide to every client
  • Good Faith Estimate process is operational for all self-pay clients
  • Mandatory reporting obligations are understood and documented
  • Art supplies are stocked and organized
  • Business bank account is open and payment processing is tested
  • Personal financial cushion is confirmed to carry you through the caseload ramp-up

Most new art therapy practices do a soft launch — starting with a reduced caseload and building referral relationships over the first six to 12 months. Clients find you through physicians, schools, word of mouth, and professional directories. Build those relationships before you need them to be fully operational.

Opening-Day Red Flags

Even after thorough planning, a few warning signs on opening day should make you stop and resolve the issue before seeing clients.

Your credential or license is not yet active. This is a hard stop. You can’t legally see clients in a clinical capacity until your required license or credential is fully in place in your state. Do not open early and “handle it later.”

You don’t have malpractice insurance in force. Seeing clients before your policy is active leaves you personally exposed to any claim that arises from those sessions — including sessions with clients in active crisis.

Your HIPAA compliance systems aren’t fully set up. If you haven’t signed BAAs with your EHR vendor, don’t have a Notice of Privacy Practices ready to give clients, or haven’t secured your digital and physical records systems, you’re not ready. Fix these before any protected health information enters your practice environment.

Your intake and consent forms haven’t been reviewed by a healthcare attorney. A poorly drafted therapy agreement, a missing mandatory reporting disclosure, or an incomplete Good Faith Estimate can expose you to legal and regulatory risk.

Your payment processing isn’t working. Test the full payment flow — from intake to charge to receipt — before your first session. Clients new to therapy often have questions about how payment works, how insurance claims are filed, and what they’ll receive from you. Being uncertain about your own billing process doesn’t inspire confidence.

Your space isn’t ready for the client population you’re seeing. A child’s first visit to a therapy room shapes whether they’ll engage or shut down. If your space is cluttered, has safety hazards accessible to a child, or doesn’t feel private, address it before opening day.

Frequently Asked Questions

Do I need a separate state license to open an art therapy practice, or is the ATR credential enough?

It depends entirely on your state. Fewer than 15 states have standalone art therapy licenses. In most states, you need a broader mental health credential — LPC, LMHC, LCSW, or similar — to practice therapy independently and use protected professional titles.

Check the ATCB’s Licensure Requirement by State page and contact your state’s health professions licensing board directly for current requirements before making any financial commitments.

How long does insurance credentialing take?

The credentialing process typically takes 60 to 180 days, and some payers take longer. Submit applications well before your planned opening date if you intend to bill insurance from day one. During the credentialing period, you can see clients on a private pay basis and hold insurance claims until your credentialing is approved.

Can I bill insurance as an art therapist?

You may be able to, but it depends on your state license type and the specific payer’s credentialing requirements. Some insurance panels credential art therapists; others require a different license type. Contact each payer’s provider relations department directly to confirm your eligibility before building your financial model around insurance revenue.

What CPT codes do art therapists use for billing?

Art therapy sessions are billed using standard psychotherapy CPT codes: 90791 for an intake evaluation, 90834 for a 45-minute individual session, 90837 for a 60-minute individual session, and 90853 for group sessions. Each code must be paired with an appropriate ICD-10 diagnosis code. Verify with each payer which codes they accept for your credential type.

Do I need a physical office, or can I run a telehealth-only practice?

A telehealth-only model is operationally possible and reduces overhead, but has real limitations for art therapy. Clients need supplies at home, the tactile and observational quality of in-person art-making is reduced, and some payers have specific requirements or restrictions on telehealth billing for art therapy. Many practitioners use a hybrid model. Verify your state’s telehealth regulations for mental health services.

What is a superbill, and when do I provide one?

A superbill is an itemized receipt that includes the session date, CPT code, ICD-10 diagnosis code, your NPI, and the fees charged. You provide it to out-of-network clients so they can submit it directly to their insurance company for reimbursement. You are not reimbursed directly — your client receives payment from their insurer.

Am I required to provide a Good Faith Estimate to every client?

Under the No Surprises Act, you must provide a written Good Faith Estimate to any client who is uninsured or not using insurance. You must inform them of this right both verbally and in writing before services begin. For ongoing clients, the estimate must be renewed every 12 months.

What is the ATR-Provisional, and can I open a practice with it?

The ATR-Provisional (ATR-P) is issued by the ATCB to graduates who have completed their degree and are working toward full ATR registration through post-graduate supervised hours. It became a required step toward the full ATR in June 2024. Whether it allows you to open an independent practice depends on your state’s laws. Some states require a full ATR or a separate state license to practice independently. Verify with your state licensing board before opening.

Advice From Art Therapy Professionals

The startup path for an art therapy private practice is more specific than a general therapy practice guide can cover. The credentialing sequence, the space requirements, the insurance billing questions, the decision about which state license you actually need — these are details that experienced art therapists in private practice have had to work out for themselves.

The resources below come from working art therapists and licensed mental health counselors who have built their own practices and shared what that process looked like from the inside.

S2E12: Amanda Shaw — Starting Over: Preparations for Moving Your Practice to a New City

Amanda Shaw, MA, LMHC, ATR, is a licensed mental health counselor and registered art therapist who owns Create Flow Heal Art Therapy & Counseling LLC in St. Petersburg, Florida.

She completed her master’s degree at George Washington University with an emphasis on trauma-informed care and art psychotherapy.

This episode of The Creative Psychotherapist podcast follows Amanda through the logistical and emotional process of rebuilding a private practice in a new city.

She covers what preparations matter most before making a geographic move with an established practice — licensing, client transitions, space selection, and community reentry.

For anyone launching a practice in a new area — or starting fresh in a city where they have no referral network yet — Amanda’s account of what to do before day one is directly applicable.

 

S2E19: Jackie Schuld — Redesigning How We Create a Practice

Jackie Schuld is a registered expressive arts therapist, board-certified art therapist (ATR-BC), and licensed professional counselor (LPC) based in Arizona, who is also autistic and ADHD.

She owns her own art therapy private practice and consults with other therapists who want to build practices that fit their real needs — not a generic model.

This episode of The Creative Psychotherapist podcast centers on how Jackie has restructured her practice to work on her terms, including the parts of conventional private practice wisdom she deliberately rejected.

She discusses fee setting, schedule design, the emotional weight of starting a business, and why the standard advice given to new therapists doesn’t always hold up in practice.

Jackie’s perspective is especially useful for therapists who want to think carefully about what kind of practice is actually sustainable — before they sign a lease or fill a caseload.

 

11.5 Steps to Starting a Private Practice — Jackie Schuld, ATR-BC, LPC

This is a written guide by Jackie Schuld, drawn from her own experience opening an art therapy and expressive arts private practice in Arizona.

She walks through every step she took — from researching her state’s specific laws for art therapists to choosing an EHR, setting her schedule, and deciding between in-person and telehealth delivery.

Her step on researching state law is particularly useful. She explains how she looked up Arizona’s art therapy title-protection rules and then cross-checked the ATCB requirements — and notes that she was given incorrect information more than once before verifying things herself.

The guide is practical and plainly written. It reflects what a working art therapist actually encountered, not a generalized checklist built for any therapy practice.

 

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