How Much Does a Nurse Practitioner Side Business Cost to Start?

Many nurse practitioners believe that starting a practice is expensive. This can discourage providers from establishing themselves as an independent business owner, preventing them from achieving financial freedom and prosperity. Read on to learn how much it truly costs to open a side business as a nurse practitioner, the affordable way.

Choosing how much capital to invest in your side practice

If a nurse practitioner were to dump $30,000+ into a startup practice which later fails, closing can be financially devastating. On the other hand, if an NP starts a small practice for $5,000 that eventually closes, the financial loss would be much easier to mitigate. It is very important to keep your startup expenses as low as possible.

I have started all my side businesses with $5,000-$10,000 each,” says Elite NP founder Justin Allan. “My startup budget was a bit higher for my telemedicine practices due to the robust marketing plan I executed. You must create an effective marketing plan to build your patient base quickly, there is no way around it. With telemedicine, marketing will be your largest expense.”

If an NP were to follow the standard practice model of insurance payment/reimbursement while employing multiple staff members, it would most likely be impossible to start up with $5,000. If you follow the Elite Nurse Practitioner Model, do not accept insurance and open a cash practice, $5,000 in startup capital can be enough.

If you take insurance, you will have more expenses compared to a cash side practice:

  • Insurance requires an expensive EMR. Cash can be accepted with paper charts or a simple EMR.
  • Insurance requires credentialing and billing services. Cash requires a simple point of sales system.
  • Insurance requires after-hours answering services. Cash does not.

What are the top business expenses for a nurse practitioner side practice?

An insurance-accepting side practice will have much higher startup costs than a cash-only side business. These are the top 3 expenses that will add up quickly for an insurance accepting side business. Let’s break down the numbers for starting up a cash practice:

Office space

You should strive to find the least expensive monthly rent price per square unit of office space. If you provide quality care, the look of your office will be less of a priority for patients. If you have a telemedicine or mobile practice, you can totally skip this step!

EMR/Patient Charting

There are a plethora of inexpensive EMRs on the market, such as Simple Practice and UniCharts. You can get started with Simple Practice for approximately $50. It can also be advantageous to use paper charting in your practice, which costs even less than digital alternatives.


Marketing will most likely be an NPs biggest expense upon startup time. A well-executed marketing plan should be the backbone of your business, and will help you reach a wider client-base and expand the size of your business. Elite NP suggests spending $500 to $1,000 per month during the initial 3 month phase of your business. The more, the better!

Accounting Software

Quickbooks is a great inexpensive option for keeping track of business finances. It also may be advantageous to brush up on your Microsoft Excel skills, which is a simple and cheap way to balance your side practice’s budget without opting for software purchases.

Malpractice Insurance

Depending on what service you provide; you will likely need a malpractice policy. If you protect your assets through other means, malpractice insurance may not be a necessary expense. In general, having a malpractice policy is a good idea for virtually all nurse practitioners. You can expect to pay around $1,000-$1,300 for this.

Office Furniture and Decor

Don’t feel the need to break the bank on high-end office furniture and decor for your side business. Stick to budget options from affordable furniture retailers, or brush up on your thrifting skills and buy second-hand decor from sources like Goodwill, Facebook Marketplace, estate sales, and more.

Medical Supplies

Larger, high-tech medical supplies can be bought second-hand. Disposable, everyday medical supplies can also be bought wholesale. Elite NP recommends using our preferred vendor network to source affordable supplies for your startup practice.

Business Liability Insurance

The majority of nurse practitioner businesses will need business liability insurance. This will protect your business against legal liabilities that are unrelated to malpractice, such as a slip and fall in your practice’s lobby. This can cost between $50 and $100 month. Many malpractice policies can add a business liability clause to your policy for no additional cost.

Budgeting overview

The grand total for starting this practice should be around $5,000, excluding marketing. If you want to start small and slow, then you can get away with spending $250 per month on basic marketing around the time of your business launch. If you want to get busy fast though, then you will need to add approximately $3,000 to that cost, so you can develop a more aggressive marketing strategy. In total, NPs are looking at $5,000-$8,000 to start a practice.

Many nurse practitioners can feasibly save $5,000 to start a business. If you cannot, it may be time to reevaluate your spending habits. If you are a new graduate or have recently been laid off and money is tight, consider taking a personal loan out from a friend or colleague. You might be able to pay them back fairly quickly. Otherwise, avoid business debt if at all possible.

“Do not let the fear of initial business startup costs prevent you from taking the plunge!” says Justin Allan. “Starting a business is a risk, but in the grand scheme of life, $5,000 is a small price for a life of financial freedom. If your practice fails, at least you can say you gave it a try. But if you create a practice providing an in-demand niche service, there is no reason why you should fail if you give it enough time.

31 Responses

  1. This is an inspiring read! I feel that most NPs aspire to one day work for themselves in some form or fashion. Do you have any examples of cash prices for services for primary/walk in care? Also, in your experience what should you expect to net on a monthly basis from a small start up practice such as the one you described? What about pay for collaborative MD? I’m in TN. Thanks!

    1. Jessica, the problem with primary care/walk in/urgent care is that it is general practice. People typically do not want to pay cash for those type of services, they want to use their insurance. You must develop a niche idea if you want to start a cash only practice. A small side practice like I described could easily net $10,000+ a month. I wouldn’t pay a MD more than $1,000 a month. Check out these articles: Cash, Physician Collaboration, Milestones. Also read the Elite NP Model basics.

      1. Excellent point, however, those without insurance are willing to pay cash for the home visit instead of going to Emergency which would end up costing them $$$$! There is a big market for this patient as well.

  2. Thank you for this post. It was very detailed and inspiring. You touched on every single concern any aspiring independent practice NP could have. Very much appreciated. You give us hope.

  3. Justin, I’m a believer in what you are doing. And I’m taking your advice to heart. Looking to start my “side practice” this year, and it will be cash only.

    1. Thanks Rex. The best time to start that business was yesterday. My advice for you is to get the ball rolling as soon as possible while you have the motivation. What are you thinking of opening?

  4. Great read! Glad to see others of like mind and the spirit to step outside the box. Cash pay for that unique business seems to be the way to go. Trying to contract with the major insurance carriers ends many times in “we have out quota of providers” yet I see patients every week that are waiting 2 weeks to 2 months to see their PCP. I’m in Arizona so I don’t require a physician collaboration. Also, I’ve found the “rural health” scene is very wide open.

    1. Spot on! Rural health is an absolute gold mine. I make a significant amount of money doing medical cannabis evaluations in rural areas. No one else wants to go.

  5. Do you recommend making this “side” business into a main business? I want to open a wellness clinic and have IV infusions (Oncology-high dose Vit C, migraines, hyperemesis, post-surgical, hangover, etc), Weight loss, vitamin injections, immune boosters, aesthetics (body sculpting, micro needing, Kybella), massages (ie; lymphatic drainage), hormone replacements. Just a few ideas, unless this is too much at once. Any advice? Thanks

    1. It sounds like you want to open a generalized wellness practice, which is great! I think doing too much at one time though can bottle neck you and create overload paralysis. For this reason, I would stick to just 3 services at first and then build from there.

      But yes, the goal is to transition into a fulltime business. Starting part-time is a risk diversion strategy and allows you to get your feet wet as you grow and flourish into an eventual fulltime business.

  6. I am interested in starting up a psychiatric business. I graduate in 6 months. I will need a collaborator. Which step do I do first? How and when can I start?

  7. is this course live, or just power point. Will it show me what “cocktails” to buy to mix different Vitamin infusions? Will it go over potential risk/contraindications for a patient.

    1. The class is recorded so you can watch it as many times as you want. Yes, the course covers all of those considerations.

  8. I’m currently 1099 with an MD, but looking to leave to start my own practice in Jan. Was thinking of doing a hybrid model, but may just start out doing cash and push hard and fast and see how it goes. Which class/ reference do you recommend to ease this transition?

    1. Hi Casie,

      Any of our courses will help you with this. We focus predomiantely on cash pay services in the courses so it will guide you. Pick a course that interests you based off the service you want to provide. Be sure to do a little market research in your area though. You don’t want to do something that is saturated!

  9. Hello Justin. I want start a telehealth psych practice but don’t know where or how to get started. Do you have any advice?

  10. I am looking to start a practice as a new NP this January. I am leaning towards membership plans for primary care, HRT and simple cosmetic and weight loss options and women and men’s sexual health (not Paps or things like that). A more wholistic , wellness facility. I don’t want this to be a side business, but rather my primary source of income (eventually). Is this offering too much? I also need a collaborating physician, as in FL we can not practice autonomously without 3000 hours. I see websites that advertise matching you with one. DO you have any thoughts on those? I have a good amount of money to start should most of that be in advertising? lots of questions. Thank you in advance.

  11. If one plans to open a brick and mortar type clinic offering simple sick visits, cash pay what would it typically cost to start something like that up?

    1. It would cost 5-10k still. But be cautious: these types of clinics typically don’t do well. people expect their insurance to cover that.

  12. Justin – Curious what your thoughts are on opening a TRT clinic; I am unsure where to start as I know I will need a MD to prescribe the medications. I would like to also offer botox/aesthetics which I can already prescribe myself.

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