If you are a therapist or mental health professional, tax rules rarely feel like something that stays still for long. Even when nothing dramatic changes, small adjustments in brackets, deductions, and thresholds can quietly affect how much you owe and how prepared you feel when tax season arrives.
The 2026 tax year is one of those periods where there is a mix of familiar rules and meaningful updates.
Some changes come from inflation adjustments, while others reflect longer-term shifts that affect self-employed professionals and small practices. Understanding what is different helps you avoid surprises and make better decisions throughout the year.
In this blog, we will walk through what are the taxes for therapists changes in 2026, why it matters for therapists, and what you can do to stay on track without adding stress to your already full schedule.
Why 2026 Matters More Than It Might Seem
Many therapists assume that if Congress does not pass a major tax overhaul, then their situation will look the same year to year. In reality, most tax changes show up in quieter ways. Income thresholds shift, deductions phase in or out, and payroll and self-employment taxes adjust slightly.
Over time, those details add up.
For therapists, this matters because income is often uneven. Caseloads change, insurance reimbursements lag, and practice growth rarely follows a straight line. When the rules shift at the same time, it becomes easier to underpay, overpay, or feel unsure about where you stand.
Federal Tax Brackets And Standard Deduction Updates
One of the most consistent changes each year is the IRS adjustment to tax brackets and the standard deduction. These updates are tied to inflation and are designed to prevent higher taxes simply because prices and income rise over time.
For 2026, the income ranges for each federal tax bracket have increased again, along with the standard deduction. This means that some of your income may be taxed at a slightly lower effective rate than in prior years, even if your revenue grows modestly.
Marginal Rates for 2026
| Marginal Tax Rate | Single Filers | Married Filing Jointly |
| 37% | Income over $640,600 | Income over $768,700 |
| 35% | Income over $256,225 | Income over $512,450 |
| 32% | Income over $201,775 | Income over $403,550 |
| 24% | Income over $105,700 | Income over $211,400 |
| 22% | Income over $50,400 | Income over $100,800 |
| 12% | Income over $12,400 | Income over $24,800 |
Standard deductions for Tax Year 2025 & 2026
| Standard deduction | Single; Married Filing Separately | Married Filing Jointly; Surviving Spouses | Heads of Households |
| TY 2025 | $15,750 | $31,500 | $23,625 |
| TY 2026 | $16,100 | $32,200 | $24,150 |
Source: IRS
For therapists, the practical takeaway is simple. If you base your tax savings or estimated payments on older numbers, you may be slightly off. Updating your assumptions for 2026 helps ensure that what you are setting aside actually matches what the IRS expects.
The Qualified Business Income Deduction Still Matters
The Qualified Business Income deduction, often called the QBI deduction, continues to be one of the most important rules for self-employed therapists and small practice owners. This deduction allows eligible business owners to deduct up to 20% of their qualified business income, subject to income limits and specific rules.
In 2026, the deduction itself remains in place, but the income thresholds that determine eligibility continue to shift. For therapists whose income is near the phase-out range, a small increase in profit can have a bigger tax impact than expected.
This is one area where accurate bookkeeping really matters. Knowing your net profit, not just your gross revenue, helps determine whether the deduction applies and how much benefit you actually receive.
Changes To Itemized And Other Common Deductions
Most therapists take the standard deduction, but itemized deductions still matter in certain situations. Charitable contributions, mortgage interest, and state and local taxes can all play a role depending on your personal and business circumstances.
The state and local tax deduction, often referred to as SALT, continues to have limits in place for 2026. While some thresholds have increased, the deduction is still capped, which can affect therapists in higher tax states.
The key point here is not to chase deductions blindly, but to understand which ones realistically apply to you. Keeping clean records of charitable giving and business-related expenses ensures that nothing is missed when it is time to file.
Self-Employment Tax And Social Security Thresholds
For most therapists who are sole proprietors or single-member LLCs, self-employment tax remains one of the biggest pieces of the tax puzzle. This tax covers Social Security and Medicare and is calculated separately from your income tax.
Each year, the Social Security wage base increases. In 2026, that means a larger portion of your income may be subject to Social Security tax before the cap is reached. While this change is incremental, it does affect total tax owed, especially for therapists with growing practices.
Understanding this helps explain why your tax bill can rise even when your income feels relatively stable. It is not always about higher rates. Sometimes it is about higher thresholds.
Business Structure Still Makes A Difference
The way your practice is structured continues to affect how you are taxed in 2026. Sole proprietors and single-member LLCs pay self-employment tax on their full net profit. S Corporation owners split their income between salary and distributions, which can reduce self-employment tax when set up properly.
There is no single right structure for every therapist. The best option depends on income level, administrative comfort, and long-term goals. What matters most is understanding how your current structure works and whether it still makes sense as your practice evolves.
What Therapists Can Do Now To Prepare
The most helpful thing you can do for 2026 is treat taxes as an ongoing process rather than a once-a-year event. Reviewing your numbers periodically, even at a high level, helps catch issues early.
Setting aside a consistent percentage of your net profit for taxes remains one of the simplest habits you can build. Many therapists find that saving 25% to 30% federally, plus state taxes if applicable, keeps them in a safe range. Having a separate tax savings account makes this much easier to manage.
Good bookkeeping is the foundation for all of this. When income and expenses are categorized correctly, your profit is clear, your estimates are easier to calculate, and tax season feels far less overwhelming.
How Traktion Accounting Supports Therapists
At Traktion Accounting, we work exclusively with therapists and mental health professionals. We understand how unpredictable income, insurance reimbursements, and practice growth intersect with tax rules in the real world.
If you want help understanding how the 2026 tax changes affect your practice, staying current with estimates, or keeping your books tax ready throughout the year, we are here to help.
Schedule a consultation and let’s make sure your finances support the work you do, not distract from it.