What your practice has to collect to match a W-2 offer

The offer is bigger than the salary line

Matching the salary is the wrong target, because the salary was never the whole of what the employer paid. Beside every W-2 paycheck sits the employer's half of Social Security and Medicare, its share of the health premium, and whatever the plan pays in retirement match. A practice has to replace all of it. So the first job is to reconstruct the employer's total spend, line by line, from documents you already have.

The payroll-tax match comes straight from the IRS's own employer guide: under the 2026 Circular E, an employer matches the employee's Social Security withholding at an equal 6.2 percent on wages up to the $184,500 wage base, a ceiling that changes annually 1Ref 1Internal Revenue Service (2026).Publication 15 (2026), (Circular E), Employer's Tax Guide.The employer-side match a W-2 clinician never sees: an equal 6.2 percent Social Security match on wages up to the $184,500 wage base for 2026, and a 1.45 percent Medicare match, unchanged from 2025, with no wage ceiling.4Ref 4Internal Revenue Service (2026).Topic no. 554, Self-employment tax.The Schedule SE mechanics: the 15.3 percent rate is generally applied to 92.35 percent of net self-employment earnings, and the Social Security wage base changes annually., and matches Medicare at 1.45 percent, a rate unchanged from 2025, with no wage ceiling at all 1Ref 1Internal Revenue Service (2026).Publication 15 (2026), (Circular E), Employer's Tax Guide.The employer-side match a W-2 clinician never sees: an equal 6.2 percent Social Security match on wages up to the $184,500 wage base for 2026, and a 1.45 percent Medicare match, unchanged from 2025, with no wage ceiling.. On a $100,000 salary that match is $7,650 a year, and none of it is inside the salary number on the offer letter.

Your benefits summary holds the health-premium line, and a national average frames it while you dig that out. In KFF's 2025 Employer Health Benefits Survey, the average annual premium for employer-sponsored coverage was $9,325 for single coverage and $26,993 for family coverage, and covered workers themselves paid roughly 16 and 26 percent of those totals 2Ref 2KFF (Kaiser Family Foundation) (2025).2025 Employer Health Benefits Survey.The national benchmark framing the health-premium line: 2025 average annual premiums of $9,325 single and $26,993 family, with covered workers paying roughly 16 and 26 percent of those totals.. On those averages the employer's share is roughly $7,800 single and $20,000 family. Your former plan's figure is the one that belongs on the worksheet. The average only sets the scale of what you are pricing.

Retirement and insurance sit in the plan documents: the match formula in the 401(k) or 403(b) summary, the employer-paid disability and life coverage in the benefits portal. Two documents do most of this work, the last W-2 and the benefits enrollment summary. Pull both before your access to the benefits portal closes, and get replacement quotes for the insurance lines while the group plan still covers you.

Self-employment tax moves both halves onto you

Self-employment tax is the payroll split made visible. The combined rate is 15.3 percent, 12.4 percent for Social Security and 2.9 percent for Medicare, the same total that a W-2 arrangement divided between your withholding and your employer's match 3Ref 3Internal Revenue Service (2024).Self-employment tax (Social Security and Medicare taxes).The combined 15.3 percent self-employment tax rate, its 12.4 and 2.9 percent parts, and the rule that the employer-equivalent half is deductible in figuring adjusted gross income.. Solo, both halves land on Schedule SE and come out of what the practice collects, which is why practice income feels more heavily taxed at the same combined rate.

The 15.3 percent applies, in general, to 92.35 percent of net self-employment earnings rather than the whole of them, computed on Schedule SE 4Ref 4Internal Revenue Service (2026).Topic no. 554, Self-employment tax.The Schedule SE mechanics: the 15.3 percent rate is generally applied to 92.35 percent of net self-employment earnings, and the Social Security wage base changes annually.. The employer-equivalent half of the tax is then deductible in figuring adjusted gross income, which lowers income tax without lowering the self-employment tax itself 3Ref 3Internal Revenue Service (2024).Self-employment tax (Social Security and Medicare taxes).The combined 15.3 percent self-employment tax rate, its 12.4 and 2.9 percent parts, and the rule that the employer-equivalent half is deductible in figuring adjusted gross income..

For 2026, the Social Security portion applies only up to the same $184,500 on either side of the employment line, whether it accrues as an employer's match on wages or as the 12.4 percent share of self-employment earnings, while the Medicare portion runs on every dollar with no ceiling 1Ref 1Internal Revenue Service (2026).Publication 15 (2026), (Circular E), Employer's Tax Guide.The employer-side match a W-2 clinician never sees: an equal 6.2 percent Social Security match on wages up to the $184,500 wage base for 2026, and a 1.45 percent Medicare match, unchanged from 2025, with no wage ceiling.. An offer near that line changes the arithmetic at the top of the worksheet.

Price the health insurance, then name the quiet benefits

Health insurance is priced with two numbers: a real quote for your own coverage, and the deduction that softens it. A marketplace or broker quote for your age, region and household replaces guessing, and the deduction is tested month by month rather than once a year. The quiet benefits are the disability and life coverage the group plan carried beside the premium, and they need individual quotes of their own.

A solo owner can generally deduct premiums through the self-employed health insurance deduction, but the test runs month by month, and the deduction is unavailable for any month you were eligible to participate in a plan subsidized by an employer, including a spouse's employer 5Ref 5Internal Revenue Service (2025).Instructions for Form 7206 (2025) — Self-Employed Health Insurance Deduction.The month-by-month eligibility test for the self-employed health insurance deduction and the disqualifier for any month of eligibility for an employer-subsidized plan, including a spouse's employer's.. Eligibility is the trigger, so a plan you could have joined counts for that month whether or not you enrolled. A year that starts on a W-2 and ends in practice is a split year on Form 7206. Put the premium on the worksheet at its full quote, then let your CPA apply whichever months qualify.

Disability and life have no national stand-in on this page. A common move is to ask the broker quoting your health plan to quote individual disability and term life in the same pass, and to enter the answers on the worksheet beside the premium.

The retirement match disappears and you fund the whole contribution

The employer's match was real money, and it goes on the replacement list at whatever the plan's formula paid. A SEP-IRA is capped for 2025 at $70,000, and at 25 percent of an employee's compensation where the plan covers employees 6Ref 6Internal Revenue Service (2025).Publication 560, Retirement Plans for Small Business (SEP, SIMPLE, and Qualified Plans).The 2025 SEP-IRA dollar ceiling of $70,000; the 25 percent limit is stated for an employee's compensation, with an owner's own contribution figured on net self-employment earnings.. An owner's own contribution is computed on net self-employment earnings after the contribution and half of the self-employment tax, which is why that line goes to the CPA rather than onto the worksheet as a percentage 6Ref 6Internal Revenue Service (2025).Publication 560, Retirement Plans for Small Business (SEP, SIMPLE, and Qualified Plans).The 2025 SEP-IRA dollar ceiling of $70,000; the 25 percent limit is stated for an employee's compensation, with an owner's own contribution figured on net self-employment earnings.. A solo 401(k) stacks two pieces: an employee-side elective deferral capped at $24,500 for 2026, up from $23,500, and an employer-side contribution on top, with combined additions capped at $72,000 for 2026 under the Section 415(c) defined-contribution limit 7Ref 7Internal Revenue Service (2026).Retirement Topics — COLA Increases for Dollar Limitations on Benefits and Contributions.The 2026 solo 401(k) figures: the $24,500 elective-deferral limit and the $72,000 overall defined-contribution addition limit under Section 415(c).. Those are the same ceilings an employer plan runs under, except that here every dollar on both sides is yours to fund. Which vehicle fits your income is a conversation for you and your CPA. The worksheet only needs the match you are replacing, in dollars.

On a W-2 the match arrived whether or not you saved. But solo, every retirement dollar starts as a collected fee, so the ceilings do their work in strong years and sit unused in lean ones.

The worksheet, from offer to collections target

No published document computes the equivalence between a W-2 offer and a practice's collections, so the worksheet below is arithmetic, built from the sourced pieces above plus your own quotes. It runs in four moves: total what the employer spends, add what the practice must buy, adjust for the tax split, then divide by the sessions you will deliver.

Fill the left column in annual dollars and total it: that is the net the practice must clear. The tax step then converts net to gross, because overhead and both halves of the payroll split come out of collections before anything reaches you.

Two lines overlap, and the overlap is easy to double-count. Adding the employer's 7.65 percent to the compensation total and then also grossing the whole figure up for the full 15.3 percent counts the same half twice. The clean version nets them, and the half-of-self-employment-tax deduction moves the answer again 3Ref 3Internal Revenue Service (2024).Self-employment tax (Social Security and Medicare taxes).The combined 15.3 percent self-employment tax rate, its 12.4 and 2.9 percent parts, and the rule that the employer-equivalent half is deductible in figuring adjusted gross income.. This is the half hour to buy from a CPA: hand over the worksheet and the offer letter, and ask for the break-even collections figure after tax.

The overhead line is the one this page cannot fill in, because it swings with the model. A telehealth cash practice and a leased office on insurance panels are different businesses wearing the same license, and the subtraction list walks the cost side of a cash practice line by line. That variation is why no single salary multiplier appears here: two clinicians holding the same offer letter can carry overhead lines that sit far apart.

Divide by the sessions you will deliver

The collections target only becomes a fee when you divide it by delivered sessions. Collections follow the sessions that happen, so the denominator is attended sessions per week times the weeks you will work, less vacation, illness, training and the administrative hours a practice adds. Divide the annual target by that number and you have a per-session floor: the fee below which the practice pays less than the offer.

The practice work (notes, scheduling, billing follow-up, the website) sits outside the sessions, so the denominator is not the caseload the employed week carried. Nothing on this page can tell you what yours will be; run the division at more than one session count and let the floor move with it.

Keep the floor and the fee separate. The floor comes out of your costs. What you actually charge is a decision about your market, and the two can sit a long way apart. If the fee your market supports sits below the floor, the gap itself is the finding: raise the fee, cut an overhead line, or take the job knowing what the comparison says. If the market fee clears the floor with room, the practice matches the salary with margin left for lean months.

Year one is its own comparison

A W-2 salary pays in full from the first pay period, and a practice pays only as the panel fills. The annual worksheet says whether the practice can match the offer at capacity; the launch question is how many months of the gap you can fund while capacity builds. Price both before answering the offer.

Where your contract and your license allow one, the conversion offer you make to existing clients is one lever on how fast the panel fills. The months before it fills are the working capital the launch has to carry, priced at the monthly gap between the salary and projected collections, and a savings cushion sized to that figure is a launch decision as real as any fee.

A prescriber runs the division over a different visit mix, shorter follow-ups against longer intakes, which is the arithmetic of the solo prescriber's schedule. A membership practice replaces per-session collections with a recurring fee, and the DPC equation sets its target as members times monthly price instead of sessions times fee.

Whatever the model, run the worksheet before you answer the offer, then run it again with the CPA's tax adjustment in place. An afternoon with the benefits summary, a set of insurance quotes and one Schedule SE projection turns the question from a feeling about private practice into a collections number you can test a fee schedule against.