Xero

Xero is a modern, full double-entry accounting platform favored by bookkeepers and CPAs for its clean reconciliation workflow, strong reporting, and multi-currency support - useful for group practices, international therapists, or anyone whose accountant prefers it. It pairs well with Gusto for payroll. It is a bookkeeping tool (not therapy-specific and not an end-to-end tax service), so most therapists use it alongside a CPA. Plans are tiered (roughly $20+/mo). Not a PHI-handling tool.