Gusto review for therapists

Quick verdict

Skip it if: your CPA already runs payroll for you and you are happy with that, or you want to keep a workers’ comp policy from another carrier managed in the same place as payroll. Gusto only integrates policies through ERGO NEXT Insurance.

Gusto is payroll, not a practice-management system. It does not touch the chart, the calendar, or claims. For those, see practice tools and practice systems.

Referral

This is a referral link. If you sign up through it, Mason may receive a referral reward. You do not pay extra. Gusto’s current terms control. Not a guarantee.

Gusto referral Gusto payroll features

The full disclosed list is on practice tools.

What Gusto does, from official docs

On its payroll features page, Gusto says it calculates, files, and pays federal, state, and local payroll taxes automatically; issues and files W-2s and 1099s; handles new-hire reporting; and supports unlimited payroll runs, including off-cycle and bonus runs. It lists weekly, every-other-week, twice-monthly, and monthly pay schedules, payroll in all 50 states, contractor payments, paid-time-off tracking, paperless onboarding, and access for your accountant or bookkeeper.

Gusto’s list of forms it files names federal Forms 941, 940, W-2, and 1099. In California it lists the DE 9 and DE 9C, plus DE 88 deposits and DE 34 new-hire reports filed electronically. The same help article says registering with state tax agencies is a separate step from filing (you can do it yourself or let Gusto help), and that employees must physically sign the state and local version of Form W-4, which you keep on file.

Plans in plain terms

From Gusto’s help article Understanding Gusto plans: Simple is single-state payroll for small teams. Plus adds multi-state payroll, time tracking, and faster pay timing. Premium adds a dedicated account partner and access to certified HR experts. Solo is for owner-only businesses with no W-2 employees besides the owner, including S corp owners. Gusto closed its contractor-only plan to new customers on October 1, 2026; contractors can be paid on any current plan.

This page does not list prices. They change, and Gusto’s own site has the current numbers.

If you pay yourself through an S corp

The IRS says an S corporation must pay a shareholder-employee reasonable compensation for the services they provide before taking non-wage distributions. If you see clients through your S corp, at least part of what you take out generally runs through W-2 payroll.

Gusto’s Solo page describes S corp owner payroll with FICA withholding, quarterly 941s, and W-2s, a reasonable-salary calculator, and a guided Form 2553 election. Whether the S corp election is worth it for you, and what salary is reasonable, are questions for your CPA. Payroll covers the employment taxes; your personal return is still yours.

Advantage Coaching, a separate business Mason runs, has a step-by-step California S corp payroll walkthrough: EDD registration, the paperwork for each employee, and which filings a payroll service handles.

If you employ associates

In California, an associate may work only as an employee or a volunteer, not as an independent contractor (Business and Professions Code 4980.43.3), and the BBS asks paid associates for W-2s when they apply for licensure (BBS AMFT FAQ). So a group practice that hires AMFTs, ASWs, or APCCs needs real W-2 payroll. That is the job Gusto does in Mason’s practice.

Plan on workers’ comp once you have an employee. Inside Gusto, only ERGO NEXT Insurance policies are supported; premiums are pay-as-you-go and calculated from each payroll. A policy from another carrier can be noted in Gusto for your records, but you manage it outside Gusto.

Gusto lets you give your CPA or bookkeeper their own access with roles and permissions. For supervision, billing, and associate setup beyond payroll, see Advantage Coaching’s group practice and associates guide.

Pros

• Federal and California payroll filings handled once you are set up: 941, 940, W-2, DE 9, DE 9C, DE 88, and DE 34, by Gusto’s own list.
• Unlimited payroll runs, including off-cycle and bonus runs.
• W-2 employees and 1099 contractors paid in one place, with year-end forms filed.
• Your CPA can get their own login with set permissions instead of a shared password.
• An owner-only plan built for S corp owners, and team plans when you hire.
• Used in practice: it runs payroll for Mason’s group practice.

Cons

• The liability stays with you. The IRS says the employer remains responsible for payroll taxes even when a payroll service files and pays them (IRS: outsourcing payroll duties).
• Agency registration is a separate step. Gusto can help, but your EDD and IRS accounts are still yours to open and keep current.
• Some paper remains. Employees have to physically sign state W-4 forms, and you keep them on file.
• Workers’ comp inside Gusto is ERGO NEXT only. Any other carrier’s policy is managed outside Gusto.
• Paying staff in more than one state needs Plus or higher. Simple is single-state.
• It is not practice software. Scheduling, notes, and insurance claims live elsewhere.

Who it fits

Solo owner-therapist in an S corp: Gusto’s Solo plan is built for this, as long as you are the only W-2 employee. Settle the salary question with your CPA first.

Small group practice with associates on W-2: Simple if everyone works in one state, Plus if you pay people in more than one. This is Mason’s use case.

Practice whose CPA already runs payroll: there may be nothing to fix. Ask what your CPA uses and what they would charge you to keep doing it.

Common questions

Sources and last checked

All links last checked 2026-10-25.

• Gusto, Payroll features — gusto.com/product/payroll/features
• Gusto Help Center, View a list of tax forms Gusto files for you — support.gusto.com … tax forms Gusto files
• Gusto Help Center, Understanding Gusto plans — support.gusto.com … understanding Gusto plans
• Gusto, Solo — gusto.com/product/solutions/size/solo
• Gusto Help Center, Manage your company’s workers’ compensation with ERGO NEXT Insurance — support.gusto.com … workers’ compensation
• Gusto Help Center, Manage roles and permissions — support.gusto.com … roles and permissions
• IRS, S corporation compensation — irs.gov … S corporation compensation
• IRS, Outsourcing payroll duties — irs.gov … outsourcing payroll duties
• California Business and Professions Code 4980.43.3 — leginfo.legislature.ca.gov
• BBS, AMFT FAQ — bbs.ca.gov … mft_faq