Gusto

Gusto is a leading small-business payroll platform widely used by group therapy practices and any practice with W-2 employees or 1099 contractors. It automates payroll runs, tax filings, direct deposit, benefits administration, and contractor payments, and integrates with accounting tools (FreshBooks, Xero, QuickBooks) and therapy-finance services like Heard. Base pricing is roughly a monthly fee plus a per-person charge. The default answer when a solo therapist hires their first employee or associate. Not a PHI-handling tool.